title: Validation and clinical utility of a simple in-home testing tool for sleep-disordered breathing and arrhythmias in heart failure: results of the Sleep Events, Arrhythmias, and Respiratory Analysis in Congestive Heart Failure (SEARCH) study.
abstract: Fifty patients with New York Heart Association class III systolic heart failure were enrolled in this prospective multicenter study that compared the diagnostic accuracy of a home-based cardiorespiratory testing system with standard attended polysomnography. Patients underwent at least 2 nights of evaluation and were scored by blinded observers. At diagnostic cutoff points of > or =5, > or =10, and > or =15 events per hour for respiratory disturbance severity, polysomnography demonstrated a sleep-disordered breathing prevalence of 69%, 59%, and 49%, respectively. Compared with polysomnography, the cardiorespiratory testing system demonstrated predictive accuracies of 73%, 73%, and 75%, which improved to 87%, 87%, and 83%, respectively, when analysis of covariance suggested reanalysis omitting one site's data. The system accurately identified both suspected and unsuspected arrhythmias. The device was judged by 80% of patients to be easy or very easy to use, and 74% of patients expressed a preference for the in-home system. Therefore, this system represents a reasonable home testing device in these patients.
authors.affiliation: The Ohio State University Heart Center, Davis Heart & Lung Research Institute, 473 West 12th Avenue, Columbus, OH 43210-1252, USA. william.abraham@osumc.edu
authors.forename: William T
authors.initials: WT
authors.lastname: Abraham
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Trupp
authors.forename: Barbara
authors.initials: B
authors.lastname: Phillilps
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bourge
authors.forename: Brian
authors.initials: B
authors.lastname: Bailey
authors.forename: Susan M
authors.initials: SM
authors.lastname: Harding
authors.forename: Peter
authors.initials: P
authors.lastname: Schofield
authors.forename: Samantha
authors.initials: S
authors.lastname: Pilsworth
authors.forename: John M
authors.initials: JM
authors.lastname: Shneerson
authors.forename: Thomas
authors.initials: T
authors.lastname: Di Salvo
authors.forename: Janice
authors.initials: J
authors.lastname: Camuso
authors.forename: Douglas
authors.initials: D
authors.lastname: Johnson
authors.forename: Martin
authors.initials: M
authors.lastname: King
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Javaheri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D006333:Heart Failure / Q000503:physiopathology*; D006699:Home Care Services; D006801:Humans; D008875:Middle Aged; D017286:Polysomnography / Q000295:instrumentation*; D011379:Prognosis; D011788:Quality of Life; D012119:Respiration; D012648:Self Care / Q000295:instrumentation*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000503:physiopathology; D011795:Surveys and Questionnaires