Sleep apnoea and Afib risk in unselected pacemaker patients

  • Marti-Almor J & al.
  • Heart Rhythm
  • 4 Sep 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In unselected pacemaker patients, severe sleep apnoea (SA) was associated with a higher incidence of significant atrial fibrillation (Afib) and persistent Afib, which increased more rapidly in severe SA patients over time.

Why this matters

  • Findings suggest that pacemakers with SA detection algorithms may have a beneficial role as a screening tool in pacemaker patients at risk for arrhythmia-associated events.

Study design

  • The REgistry of Sleep APnea monItoring and Atrial Fibrillation in pacemakeR patiEnts (RESPIRE) study assessed the association between SA and Afib in patients with dual chamber pacemakers equipped with the SA monitoring feature (n=553).
  • Funding: None disclosed.

Key results

  • At 12 months, 31.1% of patients were detected with severe SA.
  • Patients with severe SA vs those without had higher incidence of significant Afib (25.0% vs 13.9%; difference, 11.1%; 95% CI, 3.7%-18.4%; P=.002).
  • At 12 months, patients with severe SA vs those without had a higher risk of incidence of:
    • significant Afib (relative risk [RR], 1.89; 95% CI, 1.45-2.47) and
    • persistent Afib (RR, 2.29; 95% CI, 1.41-3.73).
  • Patients with severe SA vs those without had no intergroup difference in the overall rate of major serious adverse events (2.8%; 95% CI, −0.8 to 6.3%; P=.065).
  • Component analyses of patients with severe SA vs those without showed:
    • significant difference in death (5.1% vs 2.4%; 95% CI, 0.05-5.4%; P=.023) and
    • no significant difference in myocardial infarction (0.2%; P=.33), stroke (0.7%; P=.12) or re-intervention (−0.2%; P=.59).

Limitations

  • Observational design.

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