open access

Vol 80, No 2 (2022)
Original article
Published online: 2022-01-14
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Sleep-disordered breathing as a risk factor for unnecessary pacemaker implantation

Anna Szajerska-Kurasiewicz1, Danuta Loboda12, Tomasz Roleder34, Michalina Stepanik5, Jacek Durmala5, Krzysztof S Golba12
DOI: 10.33963/KP.a2022.0011
·
Pubmed: 35030262
·
Kardiol Pol 2022;80(2):191-197.
Affiliations
  1. Department of Electrocardiology, Upper-Silesian Medical Center, Katowice, Poland
  2. Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
  3. Regional Specialist Hospital, Research and Development Center, Wrocław, Poland
  4. Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
  5. Department of Rehabilitation, Medical University of Silesia, Katowice, Poland

open access

Vol 80, No 2 (2022)
Original article
Published online: 2022-01-14

Abstract

Background: Sleep-disordered breathing (SDB) is a risk factor for bradyarrhythmia, which is reversible with positive airway pressure therapy.
Aims: The study aims to evaluate the occurrence and number of severe sinus bradycardia and advanced atrioventricular block (AVB) in patients with cardiovascular diseases and SDB risk factors.
Methods: The analysis covered 207 patients with cardiovascular diseases aged 59.4 (standard deviation [SD], 10.49) years, including 177 men (85.51%), hospitalized in the Department of Electro-cardiology and the Day Stay Cardiac Rehabilitation Ward Upper-Silesian Medical Centre in Katowice, Poland. The inclusion criterion was a high risk of SDB, in particular obstructive sleep apnea (OSA), in one of the following questionnaires: the Four-Variable Screening Tool, the STOP-Bang Questionnaire, and the Epworth Sleepiness Scale. Both level-3 portable sleep tests and electrocardiogram Holter recordings were made simultaneously.
Results: SDB was confirmed in 175 (84.5%) patients, including severe in 74 (35.7%), moderate in 42 (20.3%), and mild in 59 (28.5%) participants.  The dominant type of SDB was OSA, which was found in 158 (76.3%) participants. The severe SDB was a predictor of third-degree AVB (odds ratio [OR], 11.61; 95% confidence interval [CI], 1.37–98.60), second-degree AVB type 2 (Mobitz) (OR, 4.51; 95% CI, 1.17–18.08), pauses above 3 seconds (OR, 10.26; 95% CI, 2.18–48.40), and sinus bradycardia below 40 bpm (OR, 3.00; 95% CI, 1.36–6.60) during sleep.
Conclusions: SDB, with particular emphasis on OSA, is a risk factor for sinus bradycardia and advanced AVB during sleep, which may lead to a hasty qualification for pacemaker implantation. The severity of SDB determines the frequency and number of bradyarrhythmic episodes.

Abstract

Background: Sleep-disordered breathing (SDB) is a risk factor for bradyarrhythmia, which is reversible with positive airway pressure therapy.
Aims: The study aims to evaluate the occurrence and number of severe sinus bradycardia and advanced atrioventricular block (AVB) in patients with cardiovascular diseases and SDB risk factors.
Methods: The analysis covered 207 patients with cardiovascular diseases aged 59.4 (standard deviation [SD], 10.49) years, including 177 men (85.51%), hospitalized in the Department of Electro-cardiology and the Day Stay Cardiac Rehabilitation Ward Upper-Silesian Medical Centre in Katowice, Poland. The inclusion criterion was a high risk of SDB, in particular obstructive sleep apnea (OSA), in one of the following questionnaires: the Four-Variable Screening Tool, the STOP-Bang Questionnaire, and the Epworth Sleepiness Scale. Both level-3 portable sleep tests and electrocardiogram Holter recordings were made simultaneously.
Results: SDB was confirmed in 175 (84.5%) patients, including severe in 74 (35.7%), moderate in 42 (20.3%), and mild in 59 (28.5%) participants.  The dominant type of SDB was OSA, which was found in 158 (76.3%) participants. The severe SDB was a predictor of third-degree AVB (odds ratio [OR], 11.61; 95% confidence interval [CI], 1.37–98.60), second-degree AVB type 2 (Mobitz) (OR, 4.51; 95% CI, 1.17–18.08), pauses above 3 seconds (OR, 10.26; 95% CI, 2.18–48.40), and sinus bradycardia below 40 bpm (OR, 3.00; 95% CI, 1.36–6.60) during sleep.
Conclusions: SDB, with particular emphasis on OSA, is a risk factor for sinus bradycardia and advanced AVB during sleep, which may lead to a hasty qualification for pacemaker implantation. The severity of SDB determines the frequency and number of bradyarrhythmic episodes.

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Keywords

conduction disorders, pacemaker implantation, sleep-disordered breathing

About this article
Title

Sleep-disordered breathing as a risk factor for unnecessary pacemaker implantation

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 80, No 2 (2022)

Article type

Original article

Pages

191-197

Published online

2022-01-14

Page views

885

Article views/downloads

191

DOI

10.33963/KP.a2022.0011

Pubmed

35030262

Bibliographic record

Kardiol Pol 2022;80(2):191-197.

Keywords

conduction disorders
pacemaker implantation
sleep-disordered breathing

Authors

Anna Szajerska-Kurasiewicz
Danuta Loboda
Tomasz Roleder
Michalina Stepanik
Jacek Durmala
Krzysztof S Golba

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