TY - JOUR
T1 - Atrial fibrillation-specific refinement of the STOP-Bang sleep apnoea screening questionnaire: insights from the Virtual-SAFARI study
AU - Betz, K.
AU - Verhaert, D.V.M.
AU - Gawalko, M.
AU - Hermans, A.N.L.
AU - Habibi, Z.
AU - Pluymaekers, N.A.H.A.
AU - van der Velden, R.M.J.
AU - Homberg, M.
AU - Philippens, S.
AU - Hereijgers, M.J.M.
AU - Vorstermans, B.
AU - Simons, S.O.
AU - den Uijl, D.W.
AU - Chaldoupi, S.M.
AU - Luermans, J.G.L.M.
AU - Westra, S.W.
AU - Lankveld, T.
AU - van Steenwijk, R.P.
AU - Hol, B.
AU - Schotten, U.
AU - Vernooy, K.
AU - Hendriks, J.M.
AU - Linz, D.
PY - 2023/6
Y1 - 2023/6
N2 - Background: Sleep-disordered breathing (SDB) is prevalent in up to 50% of patients referred for atrial fibrillation (AF) catheter ablation (CA). Currently, it remains unclear how to improve pre-selection for SDB screening in patients with AF. Aim: We aimed to (1) assess the accuracy of the STOP-Bang screening questionnaire for detection of SDB within an AF population referred for CA; (2) derive a refined, AF-specific SDB score to improve pre-selection. Methods: Consecutive AF patients referred for CA without a history of SDB and/or SDB screening were included. Patients were digitally referred to the previously implemented Virtual-SAFARI SDB screening and management pathway including a home sleep test. An apnoea–hypopnoea index (AHI) of ≥ 15 was interpreted as moderate-to-severe SDB. Logistic regression analysis was used to assess characteristics associated with moderate-to-severe SDB to refine pre-selection for SDB screening. Results: Of 206 included patients, 51% were diagnosed with moderate-to-severe SDB. The STOP-Bang questionnaire performed poorly in detecting SDB, with an area under the receiver operating characteristic curve (AUROC) of 0.647 (95% Confidence-Interval (CI) 0.573–0.721). AF-specific refinement resulted in the BOSS-GAP score. Therein, BMI with cut-off point ≥ 27 kg/m
2 and previous stroke or transient ischaemic attack (TIA) were added, while tiredness and neck circumference were removed. The BOSS-GAP score performed better with an AUROC of 0.738 (95% CI 0.672–0.805) in the overall population. Conclusion: AF-specific refinement of the STOP-Bang questionnaire moderately improved detection of SDB in AF patients referred for CA. Whether questionnaires bring benefits for pre-selection of SDB compared to structural screening in patients with AF requires further studies. Trial registration number: ISOLATION was registered NCT04342312, 13-04-2020. Graphical Abstract: [Figure not available: see fulltext.].
AB - Background: Sleep-disordered breathing (SDB) is prevalent in up to 50% of patients referred for atrial fibrillation (AF) catheter ablation (CA). Currently, it remains unclear how to improve pre-selection for SDB screening in patients with AF. Aim: We aimed to (1) assess the accuracy of the STOP-Bang screening questionnaire for detection of SDB within an AF population referred for CA; (2) derive a refined, AF-specific SDB score to improve pre-selection. Methods: Consecutive AF patients referred for CA without a history of SDB and/or SDB screening were included. Patients were digitally referred to the previously implemented Virtual-SAFARI SDB screening and management pathway including a home sleep test. An apnoea–hypopnoea index (AHI) of ≥ 15 was interpreted as moderate-to-severe SDB. Logistic regression analysis was used to assess characteristics associated with moderate-to-severe SDB to refine pre-selection for SDB screening. Results: Of 206 included patients, 51% were diagnosed with moderate-to-severe SDB. The STOP-Bang questionnaire performed poorly in detecting SDB, with an area under the receiver operating characteristic curve (AUROC) of 0.647 (95% Confidence-Interval (CI) 0.573–0.721). AF-specific refinement resulted in the BOSS-GAP score. Therein, BMI with cut-off point ≥ 27 kg/m
2 and previous stroke or transient ischaemic attack (TIA) were added, while tiredness and neck circumference were removed. The BOSS-GAP score performed better with an AUROC of 0.738 (95% CI 0.672–0.805) in the overall population. Conclusion: AF-specific refinement of the STOP-Bang questionnaire moderately improved detection of SDB in AF patients referred for CA. Whether questionnaires bring benefits for pre-selection of SDB compared to structural screening in patients with AF requires further studies. Trial registration number: ISOLATION was registered NCT04342312, 13-04-2020. Graphical Abstract: [Figure not available: see fulltext.].
KW - Atrial fibrillation
KW - Sleep-disordered breathing
KW - Sleep apnoea
KW - mHealth
KW - STOP-Bang questionnaire
KW - Ablation
KW - DIAGNOSIS
U2 - 10.1007/s00392-023-02157-9
DO - 10.1007/s00392-023-02157-9
M3 - Article
C2 - 36773038
SN - 1861-0684
VL - 112
SP - 834
EP - 845
JO - Clinical research in cardiology
JF - Clinical research in cardiology
IS - 6
ER -