Prospective evaluation of a Holter-ECG derived severity index for screening of sleep disordered breathing

• Verfasst von: Maier, Christoph [VerfasserIn]
• Verfasst von: Friedrich, Jörg [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Dickhaus, Hartmut [VerfasserIn]
• Titel: Prospective evaluation of a Holter-ECG derived severity index for screening of sleep disordered breathing
• Verf.angabe: Christoph Maier, PhD, Jörg Friedrich, MD, Hugo Katus, MD, Hartmut Dickhaus, PhD
• E-Jahr: 2016
• Jahr: 4 August 2016
• Umfang: 6 S.
• Fussnoten: Gesehen am 21.11.2017
• Titel Quelle: Enthalten in: Journal of electrocardiology
• Ort Quelle: New York, NY : Elsevier, 1968
• Jahr Quelle: 2016
• Band/Heft Quelle: 49(2016), 6, Seite 919-924
• ISSN Quelle: 1532-8430
• DOI: doi:10.1016/j.jelectrocard.2016.07.036
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Apnea/hypopnea index
• Sach-SW: ECG
• Sach-SW: Respiration
• Sach-SW: Respiratory event index
• Sach-SW: Screening
• Sach-SW: Sleep apnea
• K10plus-PPN: 1565577221

Abstract

BACKGROUND AND PURPOSE: To prospectively evaluate the applicability of a method to screen overnight Holter-ECGs for sleep disordered breathing (SDB) in an unselected clinical routine Holter sample. METHODS: Holter-ECG recordings in 50 cardiologic inpatients were complemented with nocturnal respiratory polygraphy (PG). The respiratory event index (REI) and apnea/hypopnea index (AHI) from the PG served as a reference for an ECG-derived SDB severity estimate using a previously developed method. Agreement with the PG was investigated using Bland-Altman plots color-coded by ectopy level, and screening accuracy for REI≥15/h and AHI≥15/h was assessed. RESULTS: Prevalence for REI≥15/h was 52%, and 32% for AHI≥15/h. We observed better agreement of the ECG-based estimate with the REI compared to the AHI. Ectopy did not limit the detection of SDB. Binary screening for REI≥15/h provided excellent specificity of 0.96 with a sensitivity of 0.77. Ternary screening for AHI≥15/h yielded 16% borderline classifications and specificity/sensitivity of 0.96/0.86 for the remaining data. CONCLUSIONS: Screening of routine Holter-ECGs for sleep disordered breathing is reasonable and promises earlier identification of a significant part of patients at no additional cost.