Left atrial appendage closure outcomes in relation to atrial fibrillation patterns: a comprehensive analysis.

Objective: The effect of atrial fibrillation (AF) patterns on outcomes remains controversial. This study aims to evaluate the influence of AF type on the risk of cardiocerebrovascular events after left atrial appendage closure (LAAC) at long-term follow-up.

Methods: AF was categorized as paroxysmal AF (PAF) and non-PAF (NPAF).

Effect of congestive heart failure on safety and efficacy of left atrial appendage closure in patients with non-valvular atrial fibrillation.

Objectives: To evaluate the influence of congestive heart failure (CHF) on safety and efficacy of left atrial appendage closure (LAAC) in non-valvular atrial fibrillation (NVAF) patients.

Methods: A total of 401 patients who consecutively underwent LAAC with Watchman and LAmbre devices were divided into CHF (85 cases) and non-CHF (316 cases) groups. Comparisons between groups were performed against data.

Comparative analysis of left atrial appendage closure efficacy and outcomes by CHADS-VASc score group in patients with non-valvular atrial fibrillation.

Background: Higher CHADS-VASc score is associated with an increased risk of adverse cardio-cerebrovascular events in patients with non-valvular atrial fibrillation (NVAF), regardless of oral anticoagulation (OAC) status. However, whether this association still exists in patients undergoing left atrial appendage closure (LAAC) is unknown. We evaluated the impact of CHADS-VASc score on LAAC efficacy and outcomes.

Left Atrial Appendage Closure Yields Favorable Cardio- and Cerebrovascular Outcomes in Patients With Non-valvular Atrial Fibrillation and Prior Stroke.

Patients with non-valvular atrial fibrillation (NVAF) and previous stroke are at significantly higher risk of stroke recurrence. Data on the efficacy of left atrial appendage closure (LAAC) on these patients is limited. The aim of this study was to investigate the differences of LAAC efficacy on long-term cardio- and cerebrovascular outcomes in NVAF patients with vs.

Response to CPAP withdrawal in patients with mild versus severe obstructive sleep apnea/hypopnea syndrome.

Background: Patients with obstructive sleep apnea/hypopnea syndrome (OSAHS), even those generally compliant with CPAP therapy, often intermittently discontinue CPAP.

Study Objective: Examine the impact of CPAP withdrawal on sleep, sleep disordered breathing (SDB), and daytime function in subjects with varying severity of OSAHS.

Patients And Interventions: Forty-two subjects (26M/16 F) with OSAHS (AHI4% = 45.

Continuous positive airway pressure treatment of sleepy patients with milder obstructive sleep apnea: results of the CPAP Apnea Trial North American Program (CATNAP) randomized clinical trial.

Rationale: Twenty-eight percent of people with mild to moderate obstructive sleep apnea experience daytime sleepiness, which interferes with daily functioning. It remains unclear whether treatment with continuous positive airway pressure improves daytime function in these patients.

Objectives: To evaluate the efficacy of continuous positive airway pressure treatment to improve functional status in sleepy patients with mild and moderate obstructive sleep apnea.

Nocturia, sleep and daytime function in stable heart failure.

Background: The aim of this study was to evaluate nocturia severity and nocturia-related differences in sleep, daytime symptoms and functional performance among patients with stable heart failure (HF).

Methods And Results: In this cross-sectional observational study, we recruited 173 patients [mean age 60.3 ± 16.

Insomnia symptoms and daytime function in stable heart failure.

Objectives: To evaluate insomnia symptoms and the extent to which they are associated with clinical and demographic patient characteristics, daytime symptoms, and functional performance in patients with stable heart failure (HF).

Design: Cross-sectional, observational.

Setting: Five structured HF disease management programs in the Northeastern U.

Sleep disturbances, quality of life, and ethnicity: the Sleep Heart Health Study.

Study Objectives: To compare health-related quality of life (HR-QOL) across subgroups defined by sleep disturbances and ethnicity.

Methods: Men (47%) and women (53%) Sleep Heart Health Study participants age 40 and older (N = 5237) underwent overnight polysomnography and completed self-report questionnaires on symptoms of sleep disturbances. The physical and mental composite scales (PCS and MCS) of the Medical Outcomes Study 36-item short form survey assessed HR-QOL and were compared to sleep data.

Sleep disordered breathing, daytime symptoms, and functional performance in stable heart failure.

Study Objectives: To evaluate characteristics of sleep disordered breathing (SDB); clinical and demographic correlates of SDB; and the extent to which SDB explains functional performance and symptoms in stable heart failure patients receiving care in structured HF disease management programs.

Design: Cross-sectional, observational study.

Setting: Structured heart failure disease management programs.

Evaluation of sham-CPAP as a placebo in CPAP intervention studies.

Study Objectives: To evaluate the use of sham-continuous positive airway pressure (CPAP) treatment as a placebo intervention.

Design And Setting: Analysis of polysomnograms performed in fixed order without sham-CPAP and on the first night of the sham-CPAP intervention in participants in the CPAP Apnea Trial North American Program (CATNAP), a randomized, placebo controlled trial evaluating the effects of CPAP treatment on daytime function in adults with newly diagnosed mild to moderate obstructive sleep apnea (apnea hypopnea index (AHI) 5-30).

Participants: The first 104 CATNAP participants randomized to the sham-CPAP intervention arm.

Relationship between reported and measured sleep times: the sleep heart health study (SHHS).

Study Objective: Subjective and objective assessments of sleep may be discrepant due to sleep misperception and measurement effects, the latter of which may change the quality and quantity of a person's usual sleep. This study compared sleep times from polysomnography (PSG) with self-reports of habitual sleep and sleep estimated on the morning after a PSG in adults.

Design: Total sleep time and sleep onset latency obtained from unattended home PSGs were compared to sleep times obtained from a questionnaire completed before the PSG and a Morning Survey completed the morning after the PSG.

Associations of sleep-disordered breathing and cerebral changes on MRI.

Study Objectives: Population-based studies have demonstrated associations between sleep-disordered breathing (SDB), hypertension, and cardiovascular disease; few large-scale studies have examined associations of SDB with objective measures of cerebrovascular disease. This study tested the significance of associations of SDB with evidence of brain injury or ischemia determined by cerebral magnetic resonance imaging (MRI) studies.

Design: Cross-sectional and longitudinal analyses in a nested sample of Cardiovascular Health Study participants in the Sleep Heart Health Study.

Sleep continuity measured by survival curve analysis.

Study Objectives: To develop and demonstrate the utility of measures of sleep continuity based on survival analysis techniques.

Design: Retrospective.

Setting: University sleep laboratory.

Choice of oximeter affects apnea-hypopnea index.

Study Objectives: Current Medicare guidelines include an apnea-hypopnea index (AHI) > or = 15 events per hour, in which all hypopneas must be associated with 4% desaturation, to qualify for reimbursement for therapy with continuous positive airway pressure (CPAP). The present data demonstrate the effect of pulse oximeter differences on AHI.

Design: Prospective study, blinded analysis.

Comparison of the maintenance of wakefulness test (MWT) to a modified behavioral test (OSLER) in the evaluation of daytime sleepiness.

The objectives were to evaluate the correlation between sleep onset as defined by the Oxford sleep resistance (OSLER) test and by simultaneous electroencephalography (EEG) and to determine the correlation between sleep latencies measured by the OSLER test and maintenance of wakefulness test (MWT) performed on the same day. This was a prospective, cross-sectional study carried out in a tertiary-care university-based sleep laboratory. Participants were 11 consecutive subjects presenting to the sleep center with clinical indications for nocturnal polysomnography and MWT.

Sleep and reported daytime sleepiness in normal subjects: the Sleep Heart Health Study.

Study Objectives: To describe the distribution of nocturnal sleep characteristics and reports of daytime sleepiness in a large well-defined group of healthy adults.

Design: The Sleep Heart Health Study is a multicenter study examining sleep and cardiopulmonary parameters through nocturnal polysomnography in adults enrolled in geographically distinct cardiovascular cohorts.

Setting: Community setting.

The addition of frontal EEG leads improves detection of cortical arousal following obstructive respiratory events.

Study Objectives: To examine the hypothesis that respiratory events in obstructive sleep apnea syndrome (OSAS) end in arousal not detected by conventional electroencephalographic (EEG) leads.

Design: Observational.

Setting: The study was conducted at a major metropolitan sleep disorders center.

Variation in symptoms of sleep-disordered breathing with race and ethnicity: the Sleep Heart Health Study.

Study Objectives: To examine the relation of sleep-related symptoms to race and ethnicity in a diverse sample of middle-aged and older men and women.

Design: Cross-sectional questionnaire survey.

Setting: In the initial phase of the Sleep Heart Health Study, men and women enrolled in participating epidemiologic cohort studies were surveyed.

Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study.

Background: Sleep-disordered breathing (SDB) is common, but largely undiagnosed in the general population. Information on demographic patterns of SDB occurrence and its predictive factors in the general population is needed to target high-risk groups that may benefit from diagnosis.

Methods: The sample comprised 5615 community-dwelling men and women aged between 40 and 98 years who were enrolled in the Sleep Heart Health Study.

The association of sleep-disordered breathing and sleep symptoms with quality of life in the Sleep Heart Health Study.

This study assessed the extent to which sleep-disordered breathing (SDB), difficulty initiating and maintaining sleep (DIMS), and excessive daytime sleepiness (EDS) were associated with impairment of quality of life (QoL) using the SF-36. Participants (n=5,816; mean age=63 years; 52.5% women) were enrolled in the nation-wide population-based Sleep Heart Health Study (SHHS) implemented to investigate sleep-disordered breathing as a risk factor in the development of cardiovascular disease.

Interobserver agreement among sleep scorers from different centers in a large dataset.

Study Objectives: To evaluate epoch by epoch agreement in sleep stage assignment between scorers from different laboratories.

Design: N/A.

Methods: 62 NPSGs were selected for analysis from 3 sleep centers (38 diagnostic studies for sleep disordered breathing [SDB], 10 studies during CPAP titration, and 14 studies in subjects with no sleep related complaints or sleep pathology).