Clinical significance of sleep-disordered breathing induced by sedatives during ablation of atrial fibrillation

Background Sleep-disordered breathing (SDB) frequently is induced by sedation during ablation of atrial fibrillation (AF). We tested whether or not sedative-induced SDB is associated with clinical sleep apnea syndrome (SAS). Methods We examined SDB observed during intra-ablation sedation with a novel portable respiratory monitor (PM), SD-101, in 140 patients undergoing AF ablation without any known SAS. A sleep study was repeated the next night of the ablation with the simultaneous use of the SD-101 and type 3 PM, APNOMONITOR V. Results The respiratory disturbance index (RDI) during sedation (20.0±7.8events/h) was significantly correlated with the RDI measured by the SD-101 during the night (15.8±13.7events/h; r =0.50) and the RDI assessed by the APNOMONITOR V during the night (12.7±12.3events/h; r =0.55). An excellent agreement was found between the RDIs simultaneously measured with the 2 PMs (intraclass correlation coefficient, 0.84), especially for an RDI of ⩾30events/h ( κ statistic value, 0.82). The area under the receiver-operating characteristic curve for the RDI with the use of the SD-101 during sedation to identify the patients with an RDI of ⩾30events/h by both PMs during the night was 0.92. A left atrial diameter of >40mm (odds ratio [OR], 4.10) and an RDI during sedation of >20events/h (OR, 17.75) were independently associated with having an RDI of ⩾30events/h with both PMs during the night. Conclusions Frequent episodes of sedative-induced SDB may have a diagnostic value for SAS in patients with AF.