TY - JOUR

T1 - Atrial fibrillation-specific refinement of the STOP-Bang sleep apnoea screening questionnaire

T2 - insights from the Virtual-SAFARI study

AU - Betz, Konstanze

AU - Verhaert, Dominique V.M.

AU - Gawalko, Monika

AU - Hermans, Astrid N.L.

AU - Habibi, Zarina

AU - Pluymaekers, Nikki A.H.A.

AU - van der Velden, Rachel M.J.

AU - Homberg, Marloes

AU - Philippens, Suzanne

AU - Hereijgers, Maartje J.M.

AU - Vorstermans, Bianca

AU - Simons, Sami O.

AU - den Uijl, Dennis W.

AU - Chaldoupi, Sevasti Maria

AU - Luermans, Justin G.L.M.

AU - Westra, Sjoerd W.

AU - Lankveld, Theo

AU - van Steenwijk, Reindert P.

AU - Hol, Bernard

AU - Schotten, Ulrich

AU - Vernooy, Kevin

AU - Hendriks, Jeroen M.

AU - Linz, Dominik

N1 - Publisher Copyright: © 2023, The Author(s).

PY - 2023

Y1 - 2023

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/m2 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/m2 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 - Ablation

KW - Atrial fibrillation

KW - mHealth

KW - Sleep apnoea

KW - Sleep-disordered breathing

KW - STOP-Bang questionnaire

UR - http://www.scopus.com/inward/record.url?scp=85147776931&partnerID=8YFLogxK

U2 - 10.1007/s00392-023-02157-9

DO - 10.1007/s00392-023-02157-9

M3 - Journal article

C2 - 36773038

AN - SCOPUS:85147776931

VL - 112

SP - 834

EP - 845

JO - Clinical Research in Cardiology

JF - Clinical Research in Cardiology

SN - 1861-0684

ER -