Atrial overdrive pacing in sleep apnoea: a meta-analysis
Bibliographic record
Abstract
AIMS: Sleep apnoea (SA) is a common breathing disorder that affects 5% of the North American adult population. It has been suggested that suppressing periods of bradycardia associated with apnoea may reduce the autonomic imbalance associated with SA, thereby improving the respiratory condition. The goals of this study were to conduct a systematic review to identify all randomized clinical trial data evaluating atrial overdrive pacing (AOP) for the treatment of SA and to perform a meta-analysis to estimate the true effect of AOP on SA. METHODS AND RESULTS: A systematic review of the literature was performed to identify all reports of the effect of AOP for the treatment of SA. To be eligible for analysis, studies had to be randomized and controlled, and use the apnoea-hypopnoea index (AHI) to determine the severity of SA. A total of 10 studies were identified, which included 175 patients with intermediate to severe SA. Overall, AOP reduced the AHI by -4.65 episodes/h [95% confidence interval (CI) -8.27 to -1.03, P = 0.01]. In comparison, studies that included a continuous positive airway pressure (CPAP) arm found a greater reduction in AHI with CPAP: -46.3 episodes/h (CI -56.2 to -36.5, P < 0.001). CONCLUSION: Although it appears that AOP is associated with a statistically significant reduction in AHI, the magnitude of this benefit is small and likely not of clinical significance. Atrial overdrive pacing should not be universally indicated in patients with SA, unless they have a conventional indication for cardiac pacing.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.009 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".