A recent study showed improvement in obstructive sleep apnea (OSA) with atrial overdrive pacing (AOP). The purpose of the present study was to replicate and extend this finding. We hypothesized that AOP improves OSA.
We enrolled 15 patients with cardiac pacemaker. Subjects underwent a screening overnight polysomnogram (PSG) to establish the diagnosis. Twelve subjects met the criteria of OSA defined as apnea + hypopnea index (AHI) > 10. Subsequently eight of the subjects underwent two consecutive nights of PSG with AOP and with low heart rate (40 beats per minute). Order of the study night was randomized. The AOP rate was set at 15 beats higher than average nightly heart rate determined during the screening PSG.
Overall our study group suffered from moderate OSA (mean AHI of 30 (+ 14) with O2 desaturation nadir of 85%. Mean AHI during AOP was 24 (+ 19) and vs for the low rate night was 32 (+ 24). There was no appreciable difference in sleep stages (including REM sleep) across the three study nights.
In our sample, AOP reduced the AHI by 25%. This trend appears to support previous work. However, to achieve statistically reliable results, a larger sample size is required.
AOP may play a role in treatment of subjects with OSA. Once an adequate sample is attained we will be able to explore responder characteristics and the optimal AOP setting for treating OSA.
H. Sharafkhaneh, None.