Department of Cardiology, Cardiovascular Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Sleep Med. 2013 Jul;14(7):622-7. doi: 10.1016/j.sleep.2013.04.003. Epub 2013 May 26.
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).
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.
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.
Frequent episodes of sedative-induced SDB may have a diagnostic value for SAS in patients with AF.
睡眠呼吸障碍（SDB）在心房颤动（AF）消融期间常因镇静而诱发。我们测试了镇静诱导的 SDB 是否与临床睡眠呼吸暂停综合征（SAS）相关。
我们使用新型便携式呼吸监测仪（PM）SD-101 检查了 140 例在没有任何已知 SAS 的情况下接受 AF 消融的患者在消融期间镇静时观察到的 SDB。在消融后的第二天晚上，同时使用 SD-101 和第三代 PM（APNOMONITOR V）重复睡眠研究。
镇静期间的呼吸紊乱指数（RDI）（20.0±7.8 次/小时）与 SD-101 在夜间测量的 RDI（15.8±13.7 次/小时；r=0.50）和 APNOMONITOR V 在夜间测量的 RDI（12.7±12.3 次/小时；r=0.55）显著相关。同时使用 2 个 PM 测量的 RDI 之间存在极好的一致性（组内相关系数，0.84），尤其是 RDI≥30 次/小时（κ 统计值，0.82）。使用 SD-101 在镇静期间的 RDI 以识别在夜间使用两个 PM 的 RDI≥30 次/小时的患者的受试者工作特征曲线下面积为 0.92。左心房直径>40mm（优势比[OR]，4.10）和镇静期间的 RDI>20 次/小时（OR，17.75）与夜间两个 PM 的 RDI≥30 次/小时独立相关。
频繁发生的镇静诱导的 SDB 可能对 AF 患者的 SAS 具有诊断价值。
