Long‐term effect of cardiac pacing on sleep‐disordered breathing in patients with conventional indications for a permanent pacemaker
Long‐term effect of cardiac pacing on sleep‐disordered breathing in patients with conventional indications for a permanent pacemaker
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心脏起搏对具有永久起搏器常规适应症的患者睡眠呼吸障碍的长期影响
DOI：
10.1016/j.joa.2014.02.003
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发表时间：
2014
影响因子：
2
通讯作者：
S. Umemura
中科院分区：
文献类型：
--
作者：
K. Matsushita;T. Ishikawa;Noritaka Toda;S. Sumita;Katsumi Matsumoto;Junya Hosoda;Yuuichiro Kimura;Y. Ogino;Yuka Taguchi;T. Ishigami;T. Sugano;S. Umemura
背景：心脏起搏对睡眠呼吸障碍的影响是有争议的。我们研究了心脏起搏对有常规适应症的永久性起搏器患者睡眠呼吸障碍的长期影响。方法纳入40例确诊有永久性起搏器适应症的患者（男性29例，平均年龄69±9岁，平均左心室射血分数69±8%，体重指数23.6±3.5 kg/m2）（病窦综合征23例，房室传导阻滞15例，brady心房颤动2例）。所有患者在植入永久性起搏器前都接受了多导睡眠图评估。植入永久性起搏器后，所有患者在使用起搏器设置期间接受多导睡眠图评估（AAI/DDD/VVI，每分钟70次）。结果平均随访时间为35±13个月。植入前，睡眠呼吸障碍患者的分布情况如下：93%的患者呼吸暂停低通气指数bbb5, 58%的患者呼吸暂停低通气指数>5,20%的患者呼吸暂停低通气指数bbb30。所有患者的平均呼吸暂停低通气指数为20±15，阻塞性呼吸暂停为4.9±5.3，中枢型呼吸暂停为3.0±4.5。Epworth嗜睡评分平均值为5.9±4.0。在随访期间，没有患者接受持续气道正压治疗或任何其他治疗睡眠呼吸障碍。植入永久性起搏器后1周的平均呼吸暂停低通气指数为21±14 (P=0.8)，随访结束时的平均呼吸暂停低通气指数为11±7 （P<0.0001）。结论长期心脏起搏可显著降低常规永久起搏器适应症患者睡眠呼吸暂停发作次数。
BackgroundThe effect of cardiac pacing on sleep‐disordered breathing is controversial. We investigated the long‐term effect of cardiac pacing on sleep disordered breathing in patients with conventional indications for permanent pacemakersMethodsSubjects comprised 40 patients (29 men; mean age 69±9 years, mean left ventricle ejection fraction 69±8%, and body mass index 23.6±3.5 kg/m2) who were diagnosed with indications for permanent pacemakers (sick sinus syndrome in 23 patients, atrioventricular block in 15, and brady atrial fibrillation in 2). All patients received polysomnographic evaluations before implantation of permanent pacemakers. After implantation of permanent pacemakers, all patients received polysomnographic evaluations during use of the pacemaker settings (AAI/DDD/VVI at 70 beats per minute).ResultsThe mean follow‐up period was 35±13 months. Before implantation, the distribution of sleep‐disordered breathing was as follows: 93% had apnea hypopnea index >5, 58% had apnea hypopnea index >15, and 20% had apnea hypopnea index >30. The mean apnea hypopnea index for all patients was 20±15, for those with obstructive type apnea was 4.9±5.3, and for those with central type apnea was 3.0±4.5. The mean Epworth Sleepiness Score was 5.9±4.0. No patient received continuous positive airway pressure therapy or any other therapy for sleep‐disordered breathing during the follow up period. The mean apnea hypopnea index at 1 week after implantation of permanent pacemakers was 21±14 (P=0.8) and the mean apnea hypopnea index at end of follow‐up was 11±7 (P<0.0001).ConclusionLong term cardiac pacing significantly reduces the number of episodes of sleep apnea in patients with conventional permanent pacemaker indications.
影响因子：
158.5
作者：
YOUNG, T;PALTA, M;BADR, S
通讯作者：
BADR, S