Accuracy and utility of a wearable medical device for ambulatory screening of obstructive sleep apnea in atrial fibrillation patients after pulmonary vein isolation ablation

Abstract Introduction Several studies have identified obstructive sleep apnea (OSA) as a risk factor for atrial fibrillation (AF) recurrence after catheter ablation, on top of other cardiovascular complications. While polysomnography (PSG) remains the gold standard for OSA diagnosis, to perform it can be both expensive and challenging because of patient acceptance and healthcare resources availability. To overcome some of the challenges and limitations, alternative diagnostic methods and devices have emerged. Purpose to evaluate the diagnostic accuracy and unattended/untrained usability in real-world conditions of a wearable medical device for screening of OSA in AF patients after ablation. Methods In patients referred for AF ablation, OSA was assessed using the Berlin and the STOP-BANG screening questionnaires, a wearable medical device validated for automated diagnosis of OSA and ambulatory PSG. The wearable device attaches to the neck and works with an accompanying self-explanatory application running on a smartphone. Diagnostic reliability between the methods and patient acceptance were evaluated. Results 21 AF patients were enrolled (age 56±8 years). Baseline characteristics of the study population described in the Table. Berlin and STOP-BANG questionnaires showed sensitivity 78% and 92% and specificity 87% and 61%, respectively. The wearable medical device showed sensitivity 90%, specificity 86%, positive-predictive value 82% and negative-predictive value 92%. Figure. All the patients reported a strong preference for the wearable medical device over PSG. Perceived satisfaction was also high with an overall score of 9,5 over 10 in the patient’s feedback test. Conclusion This wearable medical device for ambulatory screening of OSA is a reliable tool that can optimize the management of AF patients, providing an early diagnosis and a more rational use of healthcare resources.Table Figure