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.
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.
Abraham
William T
WT
The Ohio State University Heart Center, Davis Heart & Lung Research Institute, 473 West 12th Avenue, Columbus, OH 43210-1252, USA. william.abraham@osumc.edu
Trupp
Robin J
RJ
Phillilps
Barbara
B
Bourge
Robert C
RC
Bailey
Brian
B
Harding
Susan M
SM
Schofield
Peter
P
Pilsworth
Samantha
S
Shneerson
John M
JM
Di Salvo
Thomas
T
Camuso
Janice
J
Johnson
Douglas
D
King
Martin
M
Javaheri
Shahrokh
S
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