title: Analysis of interaction of acute atrial overdrive pacing with sleep-related breathing disorder.
abstract: 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.
authors.affiliation: VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA. alaa.shalaby@med.va.gov
authors.forename: Alaa A
authors.initials: AA
authors.lastname: Shalaby
authors.forename: Charles W
authors.initials: CW
authors.lastname: Atwood
authors.forename: Claudius
authors.initials: C
authors.lastname: Hansen
authors.forename: Martin
authors.initials: M
authors.lastname: Konermann
authors.forename: Roger
authors.initials: R
authors.lastname: Freedman
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fowler
authors.forename: Robert
authors.initials: R
authors.lastname: Simpson
authors.forename: Michel A Cramer
authors.initials: MA
authors.lastname: Bornemann
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kwok
authors.forename: Yachuan
authors.initials: Y
authors.lastname: Pu
authors.forename: Kent
authors.initials: K
authors.lastname: Lee
authors.forename: Jesse
authors.initials: J
authors.lastname: Hartley
authors.forename: Roger
authors.initials: R
authors.lastname: Willems
authors.forename: Joerg
authors.initials: J
authors.lastname: Neuzner
mesh_terms: 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