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Watch-PAT is Useful in the Diagnosis of Sleep Apnea in Patients with Atrial Fibrillation

Authors Tauman R, Berall M, Berry R, Etzioni T, Shrater N, Hwang D, Marai I, Manthena P, Rama A, Spiegel R, Penzel T, Koren Morag N, Pillar G

Received 30 August 2020

Accepted for publication 11 November 2020

Published 3 December 2020 Volume 2020:12 Pages 1115—1121


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Sarah Appleton

Riva Tauman,1 Murray Berall,2 Richard Berry,3 Tamar Etzioni,4 Noam Shrater,5 Dennis Hwang,6 Ibrahim Marai,7 Prasanth Manthena,8 Anil Rama,9 Rebecca Spiegel,10 Thomas Penzel,11 Nira Koren Morag,12 Giora Pillar4

1Sleep Disorders Center, Tel Aviv Souraski Medical Center, Tel Aviv, Israel; 2Center of Sleep and Chronobiology, Toronto, ON, Canada; 3UF Health Sleep Center, University of Florida, Gainesville, FL, USA; 4Technion Faculty of Medicine, Sleep Laboratory, Carmel Medical Center, Haifa, Israel; 5Cardiology Department, Soroka Medical Center, Be’er Sheva, Israel; 6Kaiser Permanente Fontana Medical Center, Fontana, CA, USA; 7Cardiology Department, Rambam Medical Center, Haifa, Israel; 8Sleep Clinic, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA; 9Kaiser Permanente San Jose Medical Center, San Jose, CA, USA; 10Stony Brook University Hospital, Stony Brook, NY, USA; 11Charite Universitätsmedizin Berlin, Sleep Medicine Center, Berlin, Germany; 12Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

Correspondence: Riva Tauman
Sleep Disorders Center, Tel Aviv Souraski Medical Center, 6 Weitzman Street, Tel Aviv 6423906, Israel
Tel +972 36974614
Fax +1 972 36974634

Background: Early diagnosis and treatment of sleep apnea in patients with atrial fibrillation (AF) is critical. The WatchPAT (WP) device was shown to be accurate for the diagnosis of sleep apnea; however, studies using the WatchPAT device have thus far excluded patients with arrhythmias due to the potential effect of arrhythmias on the peripheral arterial tonometry (PAT) amplitude and pulse rate changes.
Purpose: To examine the accuracy of the WP in detecting sleep apnea in patients with AF.
Patients and Methods: Patients with AF underwent simultaneous WP and PSG studies in 11 sleep centers. PSG scoring was blinded to the automatically analyzed WP data.
Results: A total of 101 patients with AF (70 males) were recruited. Forty-six had AF episodes during the overnight sleep study. A significant correlation was found between the PSG-derived AHI and the WP- derived AHI (r=0.80, p< 0.0001). There was a good agreement between PSG-derived AHI and WP-derived AHI (mean difference of AHI: -0.02± 13.2). Using a threshold of AHI ≥ 15 per hour of sleep, the sensitivity and specificity of the WP were 0.88 and 0.63, respectively. The overall accuracy in sleep staging between WP and PSG was 62% with Kappa agreement of 0.42.
Conclusion: WP can detect sleep apnea events in patients with AF. AF should not be an exclusion criterion for using the device. This finding may be of even greater importance in the era of the COVID19 epidemic, when sleep labs were closed and most studies were home based.

Keywords: home sleep apnea test, WatchPAT, obstructive sleep apnea, atrial fibrillation

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