Abstract 14397: Severity of Sleep Apnea in Patients Receiving Catheter Ablation of Atrial Fibrillation: A Comparison of Home Sleep Apnea Test and Polysomnography

Abstract

Introduction: Sleep apnea is highly prevalent in patients referred for catheter ablation (CA) of atrial fibrillation (AF). A watch-type peripheral arterial tonometry (WP) as a home sleep apnea test demonstrates a high degree correlation of the apnea-hypopnea index (AHI) with Polysomnography (PSG), but the evidence of the accuracy in patients with AF is not adequate. Methods: This was a single-center, retrospective, observational study. The data were derived from screening tests using WP for sleep apnea, which was routinely performed in patients scheduled to receive CA of AF in our institution. After excluding patients already diagnosed with sleep apnea, we enrolled 464 consecutive patients (age 65±11 years, 76.5% male, and 54.9% of non-paroxysmal AF) who underwent both WP and PSG. PSG was performed after the CA during hospitalization. We compared the AHI using WP with that using PSG in patients receiving CA of AF. The severity of the sleep apnea was stratified as follows: normal (AHI<5), mild (5≤AHI<15), moderate (15≤AHI<30), and severe (30≤AHI). Results: The AHI using WP (WP-AHI) was 25.9±12.7, and that using PSG was 31.4±18.9. There was a moderate correlation between the WP-AHI and AHI (r=0.48). According to the WP-AHI, the number of patients with normal, mild, moderate, and severe sleep apnea were 4 (0.9%), 85 (18.3%), 236 (50.9%), and 139 (30.0%), respectively. According to the AHI, there were 20 (4.3%), 70 (15.1%), 162 (34.9%), and 212 (45.7%) patients with normal, mild, moderate, and severe sleep apnea, respectively. In 85 patients with mild sleep apnea evaluated by WP, 38 (44.7%) and 15 (17.7%) patients were classified as moderate and severe using PSG. In 236 patients with moderate sleep apnea evaluated by WP, 100 (42.4%) were classified as severe using PSG. Conclusions: The AHI using WP was smaller than that using PSG. Further, a certain proportion of patients with mild or moderate sleep apnea using WP were diagnosed with severe sleep apnea evaluated by PSG.