Large impact of remote screening tool on sleep apnoea diagnoses in AF

A structured polygraphy screening incorporated in a novel, remote, mobile, health pathway revealed that a high proportion of patients with atrial fibrillation (AF) who were set for catheter ablation had underlying sleep apnoea (SA). Diagnosing SA in patients with AF is important since this information can be used to counsel patients on the success rates of ablation and other AF therapies. Moreover, targeted SA therapies can be initiated.

E-health is increasingly applied in heart rhythm control strategies and in screening for comorbidities such as SA. In addition, SA is difficult to diagnose in patients with AF but may contribute to AF progression. Dr Dominique Verhaert (Maastricht University Medical Center, Netherlands) and colleagues aimed to assess a structured remote polygraphy screening tool for SA in patients who were scheduled for AF ablation [1]. In total, 733 patients with paroxysmal or persistent AF were randomised to an at-home sleep test to screen for SA (n=425) or standard-of-care (n=308). In the control group, 8% of the participants had been previously diagnosed with SA while SA status was unknown in the remaining 92%. In the intervention group, 12% of the participants had been previously diagnosed with SA.

The screening intervention identified 184 new cases of SA (43%). Following the apnea-hypopnea Index (AHI), these new diagnoses included mild (16%), moderate (19%), and severe cases (8%) of SA. Furthermore, SA had been ruled out in 9% of the participants and the results were still pending at the time of the analysis for 22% of the participants. Therefore, the number of newly identified cases of SA may be even higher than the current analysis suggests. In 13% of the participants in the intervention group, SA status was still unknown because these participants preferred not to be screened (see Figure).

Figure: The impact of screening on diagnosed apnoea [1]



 

 

 

 

 

 

 

 

“This study showed that SA is highly prevalent in patients with AF who are set for catheter ablation. The knowledge of SA status is important because it provides the opportunity to initiate targeted treatments, such as continuous positive airway pressure (CPAP) therapy. The follow-up study will reveal whether these results will have an impact on AF ablation outcomes.”

1. Verhaert DVM, et al. The impact of a structured polygraphy screening incorporated in a novel remote mobile health pathway on sleep apnoea prevalence in patients with atrial fibrillation. E-Cardiology award session, EHRA 2022, 3–5 April, Copenhagen, Denmark.

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Posted on 31 May 202217 May 2024