Center of Arrhythmia, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beilishi Road 167#, Xicheng Qu, Beijing, 100037, China.
Sleep Breath. 2022 Mar;26(1):307-313. doi: 10.1007/s11325-021-02385-1. Epub 2021 May 24.
This was a pilot study to evaluate the long-term variability and burden of respiratory disturbance index (RDI) detected by pacemaker and to investigate the relationship between RDI and atrial fibrillation (AF) event in patients with pacemakers.
This was a prospective study enrolling patients implanted with a pacemaker that could calculate the night-to-night RDI. The mean follow-up was 348 ± 34 days. The RDI variability was defined as the standard deviation of RDI (RDI-SD). RDI burden was referred to as the percentage of nights with RDI ≥ 26. The patient with RDI ≥ 26 in more than 75% nights was considered to have a high sleep apnea (SA) burden. An AF event was defined as a daily AF duration > 6 h.
Among 30 patients, the mean RDI of the whole follow-up period was 24.5 ± 8.6. Nine (30%) patients were diagnosed with high SA burden. Patients with high SA burden had a higher BMI (26.7 ± 4.8 vs 23.2 ± 3.9, p = 0.036), a higher prevalence of hypertension (86% vs 39%, p = 0.031), and a larger left ventricular diastolic diameter (49.2 mm vs 46.7 mm, p = 0.036). The RDI-SD in patients with a higher burden was significantly greater than that in the patients with less burden (10.7 ± 4.9 vs 5.7 ± 1.4, p = 0.036). Linear regression showed that participants with a higher RDI tended to have a higher SD (R = 0.661; p < 0.001). The mean RDI (OR = 1.118, 95%CI 1.008-1.244, p = 0.044) was associated with AF occurrence.
Using a metric such as burden of severe SA may be more appropriate to demonstrate a patient's true disease burden.
本研究旨在评估起搏器检测到的呼吸紊乱指数（RDI）的长期变异性和负担，并探讨起搏器患者的 RDI 与心房颤动（AF）事件之间的关系。
这是一项前瞻性研究，纳入了植入能够计算夜间 RDI 的起搏器的患者。平均随访时间为 348±34 天。RDI 变异性定义为 RDI 的标准差（RDI-SD）。RDI 负担是指 RDI≥26 的夜间百分比。RDI≥26 的夜间百分比超过 75%的患者被认为具有高睡眠呼吸暂停（SA）负担。AF 事件定义为每日 AF 持续时间>6 小时。
在 30 名患者中，整个随访期间的平均 RDI 为 24.5±8.6。9 名（30%）患者被诊断为高 SA 负担。高 SA 负担患者的 BMI 更高（26.7±4.8 比 23.2±3.9，p=0.036），高血压患病率更高（86%比 39%，p=0.031），左心室舒张直径更大（49.2 毫米比 46.7 毫米，p=0.036）。负担较高患者的 RDI-SD 明显大于负担较低患者（10.7±4.9 比 5.7±1.4，p=0.036）。线性回归显示，RDI 较高的患者倾向于具有更高的 SD（R=0.661；p<0.001）。平均 RDI（OR=1.118，95%CI 1.008-1.244，p=0.044）与 AF 发生相关。
使用严重 SA 负担等指标可能更适合证明患者的真实疾病负担。
