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

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 respirato...

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Main Authors: Maier, Christoph (Author) , Friedrich, Jörg (Author) , Katus, Hugo (Author) , Dickhaus, Hartmut (Author)
Format: Article (Journal)
Language:English
Published: 4 August 2016
In: Journal of electrocardiology
Year: 2016, Volume: 49, Issue: 6, Pages: 919-924
ISSN:1532-8430
Online Access: Get full text
Author Notes:Christoph Maier, PhD, Jörg Friedrich, MD, Hugo Katus, MD, Hartmut Dickhaus, PhD

MARC

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520 |a 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. 
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