Background-Minute ventilation sensors of cardiac pacemakers measure ventilation by means of transthoracic impedance changes between the pacemaker case and the electrode tip. We investigated whether this technique migh...Background-Minute ventilation sensors of cardiac pacemakers measure ventilation by means of transthoracic impedance changes between the pacemaker case and the electrode tip. We investigated whether this technique might detect sleep-related breathing disorders. Methods and Results-In 22 patients, analog waveforms of the transthoracic impedance signal measured by the pacemaker minute ventilation sensor over the course of a night were visualized, scored for apnea/hypopnea events, and compared with simultaneous polysomnography. Analysis of transthoracic impedance signals correctly identified the presence or absence of moderate to severe sleep apnea (apnea/ hypopnea index, AHI >20 h-1) in all patients (receiver operating characteristics, ROC=10.). The ROC for AHI scores of ≥5 h-1 and 10 h-1 showed an area under the curve of 0.95, P< 0.005, and 0.97, P< 0.0001, respectively. Accuracy over time assessed by comparing events per 5-minute epochs was high (Cronbach αreliability coefficient, 0.85; intraclass correlation, 0.73). Event-by-event comparison within ±15 seconds revealed agreement in 81%(κ, 0.77; P< 0.001). Conclusions-Detection of apnea/hypopnea events by pacemaker minute ventilation sensors is feasible and accurate compared with laboratory polysomnography. This technique might be useful to screen and monitor sleep-related breathing disorders in pacemaker patients.展开更多
文摘Background-Minute ventilation sensors of cardiac pacemakers measure ventilation by means of transthoracic impedance changes between the pacemaker case and the electrode tip. We investigated whether this technique might detect sleep-related breathing disorders. Methods and Results-In 22 patients, analog waveforms of the transthoracic impedance signal measured by the pacemaker minute ventilation sensor over the course of a night were visualized, scored for apnea/hypopnea events, and compared with simultaneous polysomnography. Analysis of transthoracic impedance signals correctly identified the presence or absence of moderate to severe sleep apnea (apnea/ hypopnea index, AHI >20 h-1) in all patients (receiver operating characteristics, ROC=10.). The ROC for AHI scores of ≥5 h-1 and 10 h-1 showed an area under the curve of 0.95, P< 0.005, and 0.97, P< 0.0001, respectively. Accuracy over time assessed by comparing events per 5-minute epochs was high (Cronbach αreliability coefficient, 0.85; intraclass correlation, 0.73). Event-by-event comparison within ±15 seconds revealed agreement in 81%(κ, 0.77; P< 0.001). Conclusions-Detection of apnea/hypopnea events by pacemaker minute ventilation sensors is feasible and accurate compared with laboratory polysomnography. This technique might be useful to screen and monitor sleep-related breathing disorders in pacemaker patients.
