title: Clinical significance of sleep-disordered breathing induced by sedatives during ablation of atrial fibrillation.
abstract: BACKGROUND
  Sleep-disordered breathing (SDB) frequently is induced by sedation during ablation of atrial fibrillation (AF). We tested whether or not sedative-induced SDB is associated with clinical sleep apnea syndrome (SAS).
  
  
  METHODS
  We examined SDB observed during intra-ablation sedation with a novel portable respiratory monitor (PM), SD-101, in 140 patients undergoing AF ablation without any known SAS. A sleep study was repeated the next night of the ablation with the simultaneous use of the SD-101 and type 3 PM, APNOMONITOR V.
  
  
  RESULTS
  The respiratory disturbance index (RDI) during sedation (20.0±7.8 events/h) was significantly correlated with the RDI measured by the SD-101 during the night (15.8±13.7 events/h; r=0.50) and the RDI assessed by the APNOMONITOR V during the night (12.7±12.3 events/h; r=0.55). An excellent agreement was found between the RDIs simultaneously measured with the 2 PMs (intraclass correlation coefficient, 0.84), especially for an RDI of ≥30 events/h (κ statistic value, 0.82). The area under the receiver-operating characteristic curve for the RDI with the use of the SD-101 during sedation to identify the patients with an RDI of ≥30 events/h by both PMs during the night was 0.92. A left atrial diameter of >40 mm (odds ratio [OR], 4.10) and an RDI during sedation of >20 events/h (OR, 17.75) were independently associated with having an RDI of ≥30 events/h with both PMs during the night.
  
  
  CONCLUSIONS
  Frequent episodes of sedative-induced SDB may have a diagnostic value for SAS in patients with AF.
authors.affiliation: Department of Cardiology, Cardiovascular Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan. rjrgw059@ybb.ne.jp
authors.forename: Akinori
authors.initials: A
authors.lastname: Sairaku
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Haruo
authors.initials: H
authors.lastname: Hirayama
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nakano
authors.forename: Mamoru
authors.initials: M
authors.lastname: Nanasato
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kamiya
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kondo
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods* / Q000592:standards; D012372:ROC Curve; D015656:Respiratory Mechanics; D012890:Sleep / Q000187:drug effects; D012891:Sleep Apnea Syndromes / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D006993:Hypnotics and Sedatives
keywords: Ablation; Atrial fibrillation; Portable monitor; Respiratory disturbance index; SD-101; Sedation; Sleep-disordered breathing