Document Detail


Atrial overdrive pacing compared to CPAP in patients with obstructive sleep apnoea syndrome.
MedLine Citation:
PMID:  16126716     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Obstructive sleep apnoea (OSA) is associated with oxygen desaturation, blood pressure increase, and neurohumoral activation, resulting in possible detrimental effects on the cardiovascular system. Continuous positive airway pressure (CPAP) is the therapy of choice for OSA. In a recent study, nocturnal atrial overdrive pacing (pacing) reduced the severity of sleep apnoea in pacemaker patients. We compared the effects of CPAP with those of pacing in patients with OSA but without pacemaker indication or clinical signs of heart failure. METHODS AND RESULTS: Ten patients with OSA on CPAP therapy were studied for three nights by polysomnography. During the nights that followed a night without any treatment (baseline), the patients were treated with CPAP or pacing in a random order. Pacing was performed with a temporary pacing lead. The pacing frequency was 15 b.p.m. higher than the baseline heart rate. The apnoea-hypopnoea index was 41.0 h(-1) (12.0-66.6) at baseline and was significantly lower during CPAP [2.2 h(-1) (0.3-12.4)] compared with pacing [39.1 h(-1) (8.2-78.5)]. Furthermore, duration and quality of sleep were significantly improved during CPAP when compared with pacing. CONCLUSION: Nocturnal atrial overdrive pacing is no alternative therapeutic strategy to CPAP for the treatment of OSA in patients without clinical signs of heart failure and without conventional indication for anti-bradycardia pacing.
Authors:
Christina Unterberg; Lars Lüthje; Julia Szych; Dirk Vollmann; Gerd Hasenfuss; Stefan Andreas
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-08-26
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-15     Completed Date:  2006-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2568-75     Citation Subset:  IM    
Affiliation:
Department of Cardiology and Pneumology, Georg-August-Universität Göttingen, Robert-Koch-Str. 40, D-37099 Göttingen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cardiac Pacing, Artificial / methods*
Continuous Positive Airway Pressure / methods*
Cross-Over Studies
Electrocardiography, Ambulatory
Female
Heart Rate / physiology
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Norepinephrine / blood
Peptide Fragments / blood
Polysomnography
Sleep Apnea, Obstructive / physiopathology,  therapy*
Chemical
Reg. No./Substance:
0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 51-41-2/Norepinephrine

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