Influence of Atrial Fibrillation on Pulseoximetry Measurements ： Analysis of Portable Polygraph Measurements on Catheter Ablation Cases

摘要

Objective: Few data are available about the effect of atrial fibrillation (AF) on pulseoximetry and other parameters related sleep related breathing disorders (SRBD), and this study is aimed to clarify this. We selected the patients undergoing pulmonary vein isolation (PVI) for treatment of AF to find sinus rhythm (SR) and AF periods in the same patients.Methods: Repeated simultaneous recordings of portable polygraph and Holter electrocardiogram were performed in18 patients (average age; 65.8±11.9 years old, male 69%) who underwent PVI. The results were summarized per minute manner, and we compared Sp02， pulse rate, number of oxygen desaturation (OD) event, apnea-hypopnea (AP) event and heart rate during sinus rhythm and AF in the same patients. Results: Total 25,606 observation periods (sinus rhythm 20,332, transient AF147 and AF 5,137) in 45 simultaneous recording sessions were analyzed. The pulse rate measured by pulseoximetry was significantly lower in AF period, which suggested inadequate pulse wave detection. The discrepancy in pulse rate and heart rate was exaggerated on high heart rate in AF. Least square mean values suggest that Sp02 value was about 2% higher, and the number of OD count was about12% fewer in AF period compared to those in SR period in the same patients (p く 0.05). However, the difference was not observed in the number of AP events. Conclusions: Pulse wave detection and Sp02 measurement by pulseoximetry are unreliable in AF, especially in nigh heart rate. Oxygen-desaturation event detection may be underestimated due to unreliable pulse wave detection in AF period. Evaluation of SRBD related parameters in AF should be done understanding the relationships. [Original]