Sleep parameters in patients using pacemakers with sleep rate function on

Sleep parameters in patients using pacemakers with sleep rate function on

Autor Greco, O. T. Google Scholar
Bittencourt, LRA Google Scholar
Vargas, RNA Google Scholar
Borges, M. A. Google Scholar
Mateos, JCP Google Scholar
Neto, A. C. Google Scholar
Coelho, ODC Google Scholar
Silva, R. S. Google Scholar
Mazzo, R. A. Google Scholar
Melatto, DMB Google Scholar
Tufik, S. Google Scholar
Gauch, PRA Google Scholar
Instituição Med Sch Sao Jose Rio Preto
Universidade Federal de São Paulo (UNIFESP)
Dante Pazzaneze Cardiol Inst
St Jude Med
Resumo Introduction: the cardiovascular system (CVS) is heavily influenced by the autonomic nervous system. Additionally, there is a functional alteration during the various stages of sleep. in nonrapid eye movement (NREM), a state of cardiovascular relaxation occurs during stages three and four. A large amount of rapid ocular movements is concentrated in rapid eye movement (REM) sleep. During this phase, fluctuations in arterial pressure (AP) and heart rate (HR) can be readily noted. Sleep disordered breathing (SDB) has been associated with cardiac rhythm disorders. Recently, cardiac rhythm disorder treatment with pacemaker (PM) highlighted a reduction in abnormal respiratory events during sleep.Objective: Comparison of sleep parameters of patients using PM with a sleep rate (SR) algorithm based on its rate-modulated capability during physical activity (Integrity (TM) PM with SR function on and off).Methods: Twenty-two patients (14 women, 8 men), implanted with an Integrity PM (St. Jude Medical Cardiac Rhythm Management Division, Sylmar, CA) with SR function for standard clinical indications, were evaluated utilizing a double-blind protocol. the indication for pacing included sinus node disease (SND), atrium ventricular blockage (AVB), and atrial fibrillation (AF). Following randomization, half of our patients had SR function switched to on mode while the other half were on off mode. During the first stage of the protocol, all patients underwent two consecutive nights of polysomnographic sleep recordings (PSG). During the first night patients slept in the sleep lab only for adaptation purpose. PSG full recording was carried out in the subsequent night. At a later stage, the programing of SR functions was shifted to on or off modes. One week later, a third assessment was undertaken.Results: Twelve patients (54%) showed sleep efficiency improvement (total sleeping time/recording time) with PM SR on. This group had the least effective sleep efficiency with PM off, if compared with the others who highlighted no change in this sleep parameter (72 +/- 12 vs 81 +/- 7%, P = 0.01, respectively). This first group displayed a lower latency for REM sleep than the last one (89 +/- 55 vs 174 +/- 107 minutes, P = 0.01, respectively). in 11 (50%) patients, the number per sleep hour of microarousals was reduced when PM SR was switched on. When we compared such findings to the group whose parameters had not changed, we noted that the first set of patients were sleepier (ESE: 9 +/- 4 vs 5 +/- 5, P = 0.04, respectively), and showed more microarousals with PM SR off (20 +/- 14 vs 7 +/- 5 microarousal/hour, P = 0.007).Conclusion: in PM patients with sleep-related issues, the SR function activation improved sleep both from a qualitative and quantitative perspective.
Palavra-chave pacemakers
sleep parameters
cardiac rhythm
sleep rate
Idioma Inglês
Data de publicação 2006-02-01
Publicado em Pace-pacing and Clinical Electrophysiology. Oxford: Blackwell Publishing, v. 29, n. 2, p. 135-141, 2006.
ISSN 0147-8389 (Sherpa/Romeo, fator de impacto)
Publicador Blackwell Publishing
Extensão 135-141
Fonte http://dx.doi.org/10.1111/j.1540-8159.2006.00306.x
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000236181500003
Endereço permanente http://repositorio.unifesp.br/handle/11600/28738

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