Automatic recognition of abnormal respiratory events during sleep by a pacemaker transthoracic impedance sensor

Journal of Cardiovascular Electrophysiology
Pascal DefayeStéphane Garrigue

Abstract

A number of pacemakers use transthoracic impedance to derive minute ventilation as a sensor for rate adaptation. Transthoracic impedance is also able to track fluctuations in tidal volume occurring in sleep apnea/hypopnea syndromes (SAS). We evaluated the feasibility of a transthoracic impedance-derived pacemaker algorithm for monitoring sleep respiratory disturbances. Forty-two patients who presented with a conventional indication for DDD pacing or cardiac resynchronization underwent conventional polysomnography 1 month after implantation of a Talent trade mark 3 pacemaker (ELA Medical). The respiratory disturbance index (RDI) stored in the pacemaker memory was compared to the apnea/hypopnea index (AHI) derived from polysomnography. The ability of the pacemaker to identify severe SAS patients (AHI > or = 30) was assessed. A minimal systematic error was observed from a Bland and Altman plot (bias = 0.9 events/hour). The ability of the pacemaker RDI to identify severe SAS patients was determined by analysis of the receiver operator characteristic. A cutoff RDI value of 30.6/hour of recording was found to yield 75% sensitivity, 94% specificity, 75% positive predictive value, and 94% negative predictive value. The RDI monitoring f...Continue Reading

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Citations

Nov 29, 2005·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Fred Kusumoto, Nora Goldschlager
Jul 4, 2009·Pacing and Clinical Electrophysiology : PACE·Michael V OrlovCharles I Haffajee
Oct 14, 2006·Pacing and Clinical Electrophysiology : PACE·Irene H StevensonHarry G Mond
Oct 14, 2006·Pacing and Clinical Electrophysiology : PACE·Alaa ShalabyJoerg Neuzner
Jun 3, 2006·Clinical Cardiology·Fred M Kusumoto, Nora Goldschlager
Aug 26, 2010·Pacing and Clinical Electrophysiology : PACE·Margherita PadelettiSanja Jelic
Feb 25, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Pascal DefayeJean-Louis Pépin
Nov 29, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Ghassan MoubarakSerge Cazeau
Jul 8, 2014·Journal of Cardiovascular Medicine·Enrico VizzardiMarco Metra
Oct 18, 2006·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Emmanuel N Simantirakis, Panos E Vardas
Apr 14, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Lien DestegheDominik Linz
Oct 13, 2017·Respirology : Official Journal of the Asian Pacific Society of Respirology·Jean L PépinSairam Parthasarathy
Oct 28, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Domenico G Della RoccaAndrea Romigi
Jun 22, 2019·JACC. Clinical Electrophysiology·Dominik LinzPrashanthan Sanders
Jan 12, 2019·Journal of cardiology·Yuka TaguchiKouichi Tamura

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