522 Atrial overdrive pacing and sleep apnea in a pacemaker population

Abstract

Methods: we screened 81 consecutive patients of our outpatient clinic per marling with a dual chamber pacemaker who were not known for sleep apnea with the ESS and determined the prevalence of daytime sleepiness. All patients answered 8 questions (Question A - H) each concerning daytime sleepiness. Each question was ranked from 0 for the lowest to 3 points for the highest severity of the described symptom. A score of 8 or more points was assumed to be potentially associated with an increased risk for SDB. Results: pacing indications of the 81 patients (26 female) were: high degree av (AV) block (48%, 39 pts.), sinus node disease (SND, 35%, 28 pts.), binodal disease (BND, 12%, 10 pts.) and other (5%, 4 pts.). All patients answered the questionaire correctly. 30 patients (=37%, 704.11,5 years) had a score of 8 points or higher (= 344 points, mean 11,5 4. 3,0). 51 patients (63%, 734.14,3 years) had a score lower than 8 points (166 points, mean 3,44.2,3). Questions E, G and B had the highest predictive values concerning SDB and questions F and H had the lowest predictive value. Conclusions: in patients with implanted dual-chamber pacemakers we found a high prevalence of 37% with daytime sleepiness evaluated by ESS. ESS is a fast and simple method to screen pacemaker patients for suspected SDB. If Patients with a score of 8 or more points should be referred for further diagnostics and is potentially beneficial has to be evaluated in a prospective way.