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Related Concept Videos

Sleep Apnea01:21

Sleep Apnea

857
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
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Pulse rhythm01:30

Pulse rhythm

1.7K
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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PFA Under Deep Sedation and Non-Invasive Monitoring in Atrial Fibrillation Patients With Obstructive Sleep Apnea.

Dionyssios Leftheriotis1, Konstantinos A Papathanasiou1, Efstratios Karamanolis1

  • 12nd Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Pacing and Clinical Electrophysiology : PACE
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PubMed
Summary

Pulsed field ablation (PFA) for atrial fibrillation (AF) in patients with obstructive sleep apnea (OSA) under deep sedation is safe. Continuous monitoring showed no increased adverse events compared to patients without OSA.

Keywords:
atrial fibrillationefficacynon‐invasive monitoringobstructive sleep apneapulsed field ablationsafety

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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Medical Devices

Background:

  • Limited data exists on pulsed field ablation (PFA) under deep sedation for patients with obstructive sleep apnea (OSA).
  • Optimal periprocedural monitoring strategies for PFA in OSA patients are not well-established.
  • This study reports on PFA in atrial fibrillation (AF) patients with OSA using continuous non-invasive monitoring.

Purpose of the Study:

  • To evaluate the safety and efficacy of PFA under deep sedation in AF patients with OSA.
  • To assess the utility of a continuous non-invasive respiratory and hemodynamic monitoring protocol during PFA in OSA patients.
  • To compare adverse event incidence in OSA patients undergoing PFA versus non-OSA controls.

Main Methods:

  • A cohort of 32 AF patients with OSA undergoing PFA was compared to 60 AF patients without OSA.
  • Continuous beat-to-beat blood pressure, cerebral and peripheral tissue oximetry, and Hypotension Prediction Index (HPI) were monitored non-invasively.
  • Data analysis focused on adverse events, particularly transient decreases in cerebral saturation and blood pressure.

Main Results:

  • Transient cerebral desaturation occurred in 9% of OSA patients and 6% of controls, managed effectively.
  • Hypotension Prediction Index (HPI) elevations followed by transient blood pressure drops were observed in 28% of OSA patients and 33% of controls, responsive to fluids.
  • The duration of hypotension was similar between groups (2.69% vs. 3.23% of procedure time), with no serious complications reported.

Conclusions:

  • PFA under deep sedation in AF patients with OSA is associated with a similar incidence of adverse events compared to patients without OSA.
  • A sensitive continuous non-invasive monitoring protocol effectively detected and managed potential complications.
  • Further multicenter studies are warranted to validate these findings and the monitoring protocol.