European Heart Journal Advance Access originally published online on August 26, 2005
European Heart Journal 2005 26(23):2568-2575; doi:10.1093/eurheartj/ehi448
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Atrial overdrive pacing compared to CPAP in patients with obstructive sleep apnoea syndrome
Department of Cardiology and Pneumology, Georg-August-Universität Göttingen, Robert-Koch-Str. 40, D-37099 Göttingen, Germany
Received 14 December 2004; revised 24 May 2005; accepted 26 May 2005; online publish-ahead-of-print 26 August 2005.
* Corresponding author. Tel: +49 551 3914141; fax: +49 551 3914142. E-mail address: larsluethje{at}med.uni-goettingen.de
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 antibradycardia pacing.
Key Words: Pacing • Continuous positive airway pressure • Sleep apnoea
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. Kara, M. Novak, J. Nykodym, K. A. Bybee, J. Meluzin, M. Orban, Z. Novakova, J. Lipoldova, D. L. Hayes, M. Soucek, et al. Short-term Effects of Cardiac Resynchronization Therapy on Sleep-Disordered Breathing in Patients With Systolic Heart Failure Chest, July 1, 2008; 134(1): 87 - 93. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, D. L. Hayes, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons J. Am. Coll. Cardiol., May 27, 2008; 51(21): e1 - e62. [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, D. L. Hayes, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons Circulation, May 27, 2008; 117(21): e350 - e408. [Full Text] [PDF]
|
|
|
|
 |
|
 B. Buyse and the participants of working group 2 Treatment effects of sleep apnoea: where are we now? Eur. Respir. Rev., December 1, 2007; 16(106): 146 - 168. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Bazzano, Z. Khan, K. Reynolds, and J. He Effect of Nocturnal Nasal Continuous Positive Airway Pressure on Blood Pressure in Obstructive Sleep Apnea Hypertension, August 1, 2007; 50(2): 417 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Garrigue, J.-L. Pepin, P. Defaye, F. Murgatroyd, Y. Poezevara, J. Clementy, and P. Levy High Prevalence of Sleep Apnea Syndrome in Patients With Long-Term Pacing: The European Multicenter Polysomnographic Study Circulation, April 3, 2007; 115(13): 1703 - 1709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Eckert, A. S. Jordan, P. Merchia, and A. Malhotra Central Sleep Apnea: Pathophysiology and Treatment Chest, February 1, 2007; 131(2): 595 - 607. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. T. McNicholas, M. R. Bonsignore, and the Management Committee of EU COST ACTION B26 Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities Eur. Respir. J., January 1, 2007; 29(1): 156 - 178. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Arzt and T. D. Bradley Treatment of Sleep Apnea in Heart Failure Am. J. Respir. Crit. Care Med., June 15, 2006; 173(12): 1300 - 1308. [Abstract] [Full Text] [PDF]
|
|