Cardiac resynchronization therapy for the treatment of sleep apnoea: a meta-analysis
Bibliographic record
Abstract
AIMS: Sleep apnoea (SA) is a common problem among congestive heart failure (CHF) patients. Evidence has shown that cardiac resynchronization therapy (CRT) reduces morbidity and mortality associated with CHF. The aim of this paper was to review studies evaluating the reduction of the Apnoea-Hypopnoea Index (AHI) in patients with SA after treatment with CRT and to perform a meta-analysis to estimate the true effect of CRT on SA. METHODS AND RESULTS: A systematic electronic literature search was conducted in Medline and Embase to identify studies reporting on the effects of CRT on SA. A hand search of five major cardiology societies was performed to identify any unpublished studies through structured abstracts submitted to conference proceedings. To be eligible for inclusion, studies had to include a comparison of CRT vs. no pacing and use AHI as an outcome. Non-English studies were excluded. Nine manuscripts and five abstracts were identified for review. Six manuscripts and three abstracts were included in meta-analysis, which included 170 patients. After treatment with CRT, a significant reduction in AHI was found in patients with central sleep apnoea (CSA) with a mean reduction of -13.05 (CI -16.74 to -9.36; P < 0.00001) but not in patients with obstructive sleep apnoea (13.32; CI -9.04 to 2.39; P = 0.25). CONCLUSION: Cardiac resynchronization therapy reduces the severity of SA. Major effects are seen in patients with CSA. The presence of SA may be an additional consideration when deciding on which heart failure patients will receive CRT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.020 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.051 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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 source (direct Gemma or distilled Codex), 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".