Atrial Pacing Reduces Sleep Apnea Episodes

An adjustable pacemaker has been found to significantly reduce the number of apnea episodes in patients with sleep apnea, according to a research team headed by Stephane Garrigue, M.D., of the cardiac pacing and clinical electrophysiology department, Cardiology Hospital of Haut-Leveque (Pessac, France). Their study was published in the February 7, 2002, issue of The New England Journal of Medicine.

The study involved 15 patients with central or obstructive sleep apnea who had received permanent atrial-synchronous ventricular pacemakers for symptomatic sinus bradycardia.
All patients underwent a base-line evaluation on the first night, an evaluation of one night in spontaneous rhythm, and an evaluation of one night in dual-chamber pacing mode with atrial overdrive. The latter was 15 beats faster per minute than the mean nocturnal sinus rate. The researchers analyzed and compared the total duration and number of episodes of central or obstructive sleep apnea or hypopnea.

The 24-hour sinus rate during spontaneous rhythm was around 57 beats per minute, with about nine episodes of hypopnea. In contrast, the sinus rate with atrial overdrive pacing was around 72 beats per minute, with about three episodes of hypopnea. For both apnea and hypopnea, the index was about 28 in spontaneous rhythm, compared to about 11 with atrial overdrive pacing. The researchers concluded that the atrial overdrive pacing significantly reduces the number of episodes of central or obstructive sleep apnea without reducing total sleep time.






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