Analysis of interaction of acute atrial overdrive pacing with sleep-related breathing disorder.
Dose-related effects of atrial overdrive pacing (AOP) on sleep-related breathing disorder (SRBD) were studied. Fourteen patients with pacemakers with moderate to severe SRBD (mean screening apnea-hypopnea index [AHI] 35.2 +/- 21.9 events/hour) were randomized to 3 levels of pacing (50, 10, and 20 beats/min greater than the mean nocturnal heart rate) and studied by polysomnography, observing for changes in AHI. At the 2 AOP levels, no significant change was observed in the primary end point of reduction in AHI. Additionally, there was no observed impact on secondary end points of the study. Cyclic variation of heart rate was progressively abolished with higher levels of AOP without affecting AHI. Large variations were observed between the screening and control studies in SRBD indexes in a number of patients. In conclusion, AOP demonstrated no benefit to predominantly obstructive SRBD disorder of at least moderate severity.
Shalaby
Alaa A
AA
VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA. alaa.shalaby@med.va.gov
Atwood
Charles W
CW
Hansen
Claudius
C
Konermann
Martin
M
Freedman
Roger
R
Fowler
Jeffrey
J
Simpson
Robert
R
Bornemann
Michel A Cramer
MA
Kwok
Jonathan
J
Pu
Yachuan
Y
Lee
Kent
K
Hartley
Jesse
J
Willems
Roger
R
Neuzner
Joerg
J
D000368:Aged; D000704:Analysis of Variance; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D018579:Patient Selection; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000517:prevention & control*; D016896:Treatment Outcome