A majority of patients with pacemakers in a recent series were found to have previously undiagnosed, predominantly obstructive, and often severe sleep apnea. The incidence reached 68% among those with atrioventricular block as the indication for pacing.
"Systematic screening of these patients should be performed owing to the potential cardiovascular consequences of sleep apnea syndrome," write the study's authors, Stéphane Garrigue, MD, PhD, from University of Bordeaux and Grenoble in Grenoble, France, and associates, who acknowledge that how best to manage sleep apnea in patients with pacemakers remains unclear.
To be practical, any such screening would likely not involve full sleep studies but, rather, would be limited to simpler assessments such as pulse oximetry and nasal flow measurement, according to coauthor Patrick Lévy, MD, PhD, from the University of Bordeaux and Grenoble. In patients with appropriately equipped pacemakers, he told heartwire, sleep apnea syndrome could be revealed by assessment of nocturnal tidal volumes from measurement of transthoracic impedance, a technique previously demonstrated by his group as well as others.
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