title: Sleep disordered breathing and arrhythmia burden in pacemaker recipients.
abstract: BACKGROUND
  Sleep disordered breathing (SDB), a common condition among patients with permanent pacemaker (PM), is associated with greater incidence of cardiac arrhythmias. Scarce availability of sleep laboratories and the high costs of nocturnal-attended polysomnography limit the routine screening of patients with PM for SDB. We investigated whether a novel PM that utilizes variations in transthoracic impedance to record the fluctuations in breathing pattern and minute ventilation could be used to screen patients for SDB.
  
  
  METHODS
  Twenty patients who underwent dual-chamber PM implantation were studied. The Talent 3 DR PM (SORIN Group Italy S.r.l., Milan, Italy) calculates apnea-hypopnea index (AHI) by computing minute ventilation signal derived from transthoracic impedance measurements. Within a month after PM implantation, an in-home respiratory monitoring was performed to evaluate the accuracy of PM-derived AHI. Patients were followed for mean ± standard deviation, 487 ± 166 days. The PM was checked at each follow-up visit to retrieve the information about recurrent arrhythmias.
  
  
  RESULTS
  Eleven patients were diagnosed with SDB by an in-home respiratory monitoring. An AHI derived from an in-home respiratory monitoring was similar to pacemaker-derived AHI (27 ± 14 vs 16 ± 13 events/hour, P = 0.15). The cumulative incidence of cardiac arrhythmias, including atrial fibrillation, extrasystolic beats, sustained and nonsustained ventricular tachycardia, and supraventricular tachycardia was similar in patients with and without SDB.
  
  
  CONCLUSIONS
  SDB is highly prevalent in patients with permanent pacemaker. Screening for SDB with Talent 3 DR PM may facilitate diagnosis and treatment of SDB.
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy. marghepadeletti@yahoo.com
authors.forename: Margherita
authors.initials: M
authors.lastname: Padeletti
authors.forename: Simone
authors.initials: S
authors.lastname: Vignini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ricciardi
authors.forename: Paolo
authors.initials: P
authors.lastname: Pieragnoli
authors.forename: Valerio
authors.initials: V
authors.lastname: Zacà
authors.forename: Michele
authors.initials: M
authors.lastname: Emdin
authors.forename: Stefano
authors.initials: S
authors.lastname: Fumagalli
authors.forename: Sanja
authors.initials: S
authors.lastname: Jelic
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D002307:Cardiography, Impedance / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012119:Respiration; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000503:physiopathology