16-56: Sleep Apnea Syndrome in a Multicentric Study on Patients with Device Remote Monitoring System

Abstract

Background: Sleep apnea syndrome (SAS) has up to 60% prevalence in the Pacemaker population, with 80% remaining undiagnosed. The ApneaScan TM is an implanted impedance-based respiratory sensor system embedded with Boston Scientific defibrillator devices: apneic events are expressed with the Apnea Hypopnea Index (AHI) (i.e the average number of events per hour of sleep). The aim of the study was to describe the prevalence of SAS in a french population of patients implanted as well as with a pace-maker or an implanted cardioverter defibrillator using the ApneaScan. Methods: In this 4-centers study, we retrospectively included 118 patients who had a Boston Scientific device with remote monitoring follow-up. The AHI was used to classify the severity of the sleep apnea, mild :5-14 events per hour of sleep, moderate : between 15-29, severe : more than 30. Results: Among the 118 patients (mean age, 68 ±14 years), 55% had a severe sleep apnea (average of AHI 44.9 ± 12.9/h) and 31% a moderate sleep apnea (AHI 22.9 ± 4.3/h); 46 patients were implanted with a dual chamber pace maker, 72 patients with an implantable cardioverter defibrillator (ICD): 41 dual chamber ICD and 31 CRT-D. The AHI was comparable in the CRT-D patients (AHI 29.2 ± 14.7/h), dual chamber ICD patients (32.5 ±17.2/h) or dual chamber pace-maker patients (36.1 ± 18.1/h) (ANOVA p = 0.222). An inverse correlation between the percentage of atrial pacing and the AHI (r = -0.25 p = 0.002) was found. The percentage of patient activity level (% per day) was inversely correlated with the AHI (r = -0.269 p = 0.005). The AHI was correlated with the age of patients (r = 0.2990, p = 0.0010). The percentage of ventricular pacing had no influence on AHI (p = 0.120). Conclusion: High prevalence of sleep apnea syndrome was found in patients implanted with device as well pacemaker or defibrillator. There were no differences of prevalence between patients implanted with pace-maker, ICD or CRT-D. Preliminary results identified a profile of patients at risk.