{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T03:34:38Z","timestamp":1773027278419,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sleep apnea (SA) is a risk factor for atrial fibrillation (AF). Advanced pacemakers are now able to calculate indexes of SA severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>We investigated the changes in pacemaker\u2010measured indexes of SA, we assessed their predictive value for AF occurrence and the associated risk of stroke and death at long\u2010term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 439 recipients of a pacemaker endowed with an algorithm for the calculation of a Respiratory Disturbance Index (RDI). The RDI variability was measured over the first 12\u2009months after implantation, as well as its potential association with the occurrence of AF, defined as device\u2010detected cumulative AF burden \u22656 hoursours in a day.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The individual RDI mean was 30\u2009\u00b1\u200918 episodes\/h, and the RDI maximum was 59\u2009\u00b1\u200921 episodes\/h. RDI \u226530 episodes\/h was detected in 351 (80%) patients during at least one night. The proportion of nights with RDI \u226530 episodes\/h was 14% (2%\u201036%). AF \u22656 hours was detected in 129 (29%) patients during the first 12\u2009months. The risk of AF was higher in patients with RDI maximum \u226563 episodes\/h (HR:1.74; 95%CI: 1.22\u20102.48; <jats:italic>P<\/jats:italic> = .001) and with RDI mean\u2009\u2265\u200946 episodes\/h (HR:1.63; 95%CI: 1.03\u20102.57; <jats:italic>P<\/jats:italic> = .014). The risk of all\u2010cause death or stroke was higher in patients with AF burden \u22656 hours (HR:1.75; 95%CI: 1.06\u20102.86; <jats:italic>P<\/jats:italic> = .016). Moreover, among patients with no previous history of AF the risk was higher in those with RDI maximum \u226563 episodes\/h (HR:1.96; 95%CI: 1.06\u20103.63; <jats:italic>P<\/jats:italic> = .031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pacemaker\u2010detected SA showed a considerable variability during follow\u2010up. We confirmed the association between RDI and higher risk of AF, and we observed an association between higher RDI maximum and all\u2010cause death or stroke among patients with no previous history of AF.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23489","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T11:54:37Z","timestamp":1605182077000},"page":"1609-1615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Continuous monitoring of <scp>sleep\u2010disordered<\/scp> breathing with pacemakers: Indexes for risk stratification of atrial fibrillation and risk of stroke"],"prefix":"10.1002","volume":"43","author":[{"given":"Andrea","family":"Mazza","sequence":"first","affiliation":[{"name":"Cardiology Division S. Maria della Stella Hospital  Orvieto Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Grazia","family":"Bendini","sequence":"additional","affiliation":[{"name":"Cardiology Division S. Maria della Stella Hospital  Orvieto Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Leggio","sequence":"additional","affiliation":[{"name":"Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit, S. Filippo Neri Hospital  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"De Cristofaro","sequence":"additional","affiliation":[{"name":"Cardiology Division S. Maria della Stella Hospital  Orvieto Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Valsecchi","sequence":"additional","affiliation":[{"name":"Rhythm Management Division, Boston Scientific  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia  Modena 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