Atrial overdrive pacing in patients with sleep apnea with implanted pacemaker

2005 | journal article; research paper. A publication with affiliation to the University of Göttingen.

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​Atrial overdrive pacing in patients with sleep apnea with implanted pacemaker​
Lüthje, L. ; Unterberg-Buchwald, C. ; Dajani, D.; Vollmann, D.; Hasenfuß, G.   & Andreas, S. ​ (2005) 
American Journal of Respiratory and Critical Care Medicine172(1) pp. 118​-122​.​ DOI: 

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Lüthje, L. ; Unterberg-Buchwald, Christina ; Dajani, D.; Vollmann, D.; Hasenfuß, G. ; Andreas, S. 
Rationale: Atrial overdrive pacing markedly improved sleep-disordered breathing in a recent study. Objectives: Using a single-blind, randomized, crossover design, we aimed to reproduce these findings and investigate the possible underlying mechanisms. Methods: Twenty ambulatory patients with an implanted pacemaker or cardioverter defibrillator were studied by polysomnography on 3 consecutive nights in a randomized, single-blind, crossover study in which devices were programmed for nonpacing or for overdrive pacing at 7 or 15 beats/minute faster than the mean nocturnal heart rate. Ventilation and biomarkers (urinary norepinephrine excretion, amino-terminal portion of the precursor of brain natriuretic peptide, or NT-proBNP, were also evaluated. Measurements and Main Results: Neither the primary endpoint apnea-hypopnea index, nor the apnea index, oxygen desaturation, ventilation, or biomarkers were affected by the nocturnal atrial overdrive pacing. A small, clinically insignificant, rate-dependent reduction in the hypopnea index was evoked by pacing (nonpacing, 13.4 +/- 1.4; pacing 7, 12.9 +/- 1.4, pacing 15, 10.9 +/- 1.0; p < 0.01, analysis of variance). Conclusions:The lack of effect on the apnea-hypopnea index means that atrial overdrive pacing is inappropriate for treating sleep-disordered breathing.
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American Journal of Respiratory and Critical Care Medicine 



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