Sleep apnea syndrome in patients with cardiac pacemaker

Background: Heart rhythm disturbances are cardiac side effects in patients with sleep-disordered breathing (SDB), which in itself is considered to be a risk factor for bradycardic rhythm disturbances. Objective: We analyzed the prevalence and degree of SDB in patients who received a cardiac pacemaker due to bradycardic rhythm disturbances and investigated the relationship between the severity of an underlying SDB and the type of heart rhythm disturbance. Methods and Results: 192 patients (100 males, 92 females, mean age 62.2 +/- 12.2 years) were studied using the portable screening device ME-SAM IV. The respiratory disturbance index (RDI) was calculated visually. The mean RDI in all patients was 9.13 +/- 11.09/h, 11.7 +/- 13.15/h in males and 6.33 +/- 7.42/h in females. The prevalence ratio of SDB between men and women was 1.7:1, with significant differences in the respective severity (p < 0.05), The screening showed a prevalence of SDB (RDI > 10/h) of 32.3%. The highest prevalence was found in the group of patients with atrial fibrillation and bradycardia. However, there were no significant differences compared to other types of rhythm disturbances. The RDI in the population studied depended on age and body mass index, but not on the existence or type of rhythm disturbance and not on concomitant diseases. Conclusion: The prevalence of SDB in cardiac pacemaker patients is similar to that in patients of comparable age without a pacemaker. A heart rhythm disturbance does not seem to be an independent risk factor for development of SDB. Nevertheless, the differential diagnosis of bradycardic rhythm disturbances in this age group should include a screening for sleep apnea, Copyright (C) 2000 S. Karger AG, Basel.