0502 Watchpat Is Accurate In The Diagnosis of Sleep Apnea in the Presence of Atrial Fibrillation

• Published in: Sleep (New York, N.Y.) Vol. 42; no. Supplement_1; p. A201
• Main Authors: Pillar, Giora, Etzioni, Tamar, Berall, Murray, Henkin, Yaakov, Hwang, Dennis, Ibrahim, Marai, Litman, Efrat, Sheffy, Koby, Manthena, Prasanth, Penzel, Thomas, Rama, Anil, Spiegel, Rebbeca, Tauman, Riva
• Format: Journal Article
• Language: English
• Published: Westchester Oxford University Press 13.04.2019
• Subjects: Cardiac arrhythmia; Sleep apnea
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsz067.500

Introduction The WatchPAT is a Home Sleep Testing device which has been shown to be accurate for diagnosing obstructive sleep apnea (SA). Studies so far excluded patients with arrhythmias as the potential effect on Peripheral Arterial Tone amplitude and rate changes had not been validated. We therefore sought to examine the accuracy of the WatchPAT in detecting SA in patients with atrial fibrillation (AF). Methods 101 patients (70 males) previously diagnosed with AF (permanent/persistent/ paroxysmal/unknown type), aged 68.5±11.7 years, with suspected SA, underwent simultaneous recording of full night in-lab polysomnography (PSG) and WatchPAT (Itamar-Medical, Caesarea, Israel), in 10 medical centers. PSG scoring was performed blinded to the automatic scoring of the WatchPAT. Results Of the 101 patients, 46 patients had AF episodes during the study night: 38 had AF episodes throughout the entire night and 8 had AF episodes part of the night. The presence of AF episodes did not cause significant non-valid PAT signal. Using a threshold AHI ≥ 15, the sensitivity and specificity of the WatchPAT for all 101 patients were 0.88 and 0.63, respectively. Significant correlation was found between AHI assessed by PSG and by WatchPAT (r=0.8, p<0.01). This correlation remained significant also for the 56 subjects using antiarrhythmic medications (r=0.82, p<0.01). Similarly significant correlation was also found for the subgroup of 46 patients with AF episodes (r= 0.8, p<0.01). The overall accuracy in sleep staging between WatchPAT and PSG based on an epoch-by-epoch comparison was 62% (compared to the previously reported 65% in the general population) with a Kappa agreement of 0.42 (compared to the previously reported 0.47 in general population). Conclusion These findings suggest that WatchPAT can accurately detect SDB events in patients with AF, and that AF should not be an exclusion criterion for using this device. Support (If Any) The study was supported by an unrestrictive grant from Itamar-Medical.