Bradycardia Clinical Trial
Official title:
Registry of Sleep Apnea Monitoring and Atrial Fibrillation in Pacemaker Patients
The purpose of the study is to evaluate at 12 Months follow-up the association between Atrial Fibrillation (AF) and Sleep Apnea (SA) severity based on data measured and stored in REPLY 200 DR pacemaker.
The object of the investigation relates to the function named Sleep Apnea Monitoring or SAM
function. This function is part of the REPLY 200 DR pacemakers, whose intended use is cardiac
pacing. Sleep Apnea Syndrom (SAS) causes serious social and economic problems, not only
because of its high prevalence but also because it is associated with increased
cardiovascular morbidity and mortality.
Patients with Sleep Apnea often have arterial and pulmonary hypertension, a high risk of
coronary artery disease, and heart failure, whereas a high percentage of patients show heart
rhythm disturbances. In addition, these patients are at increased risk of being involved in
traffic accidents, as well as suffering a decline in their family, social, and professional
lives. Therefore, the prompt diagnosis of these patients could be of great importance. Today
the gold standard for the diagnosis of SAS is overnight polysomnography (PSG) in a sleep
laboratory. However, the shortage of sleep laboratories and the high cost of PSG render this
method inadequate for widespread screening. For these reasons, in recent years, there have
been attempts to develop alternative diagnostic with a view to simplify the diagnosis.
Thanks to the feature SAM included in the pacemaker, sequences of respiratory cycles are
analyzed to detect, to count and to report abnormal breathing events during the night. This
analysis is based on the Minute Ventilation (MV) signal. The MV signal represents the real
time expansion/contraction of the thorax of the patient. It is derived of the transthoracic
impedance periodic measurements. The device is able to provide the physician with day-by-day
Respiratory Disturbance Index (RDI) equal to the sum of events divided by the number of hours
per night. Physician will also access to the total number of events over the previous night
presented per hour.
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