0293 Evaluation of a Single Point of Contact Chest-worn HSAT with ECG-based Atrial Fibrillation Detection

Abstract Introduction Obstructive sleep apnea (OSA) is highly prevalent, underdiagnosed, and often comorbid with cardiac arrhythmias such as atrial fibrillation (AF). Existing home sleep apnea tests (HSATs) remain complex, often requiring multiple points of contact, and do not provide gold-standard ECG-based arrhythmia detection. A simplified HSAT with expanded capabilities for ECG-based arrhythmia detection could bridge this diagnostic gap, stimulate sleep-cardiology collaborations, and reduce patient burden; resulting in more comprehensive, patient-centered care. Here we performed a comparative PSG evaluation of the Sansa device (Huxley Medical, Inc.), a single point of contact HSAT worn on the chest that provides heart rate, oximetry, respiratory effort, total sleep time (TST), and ECG. Methods Patients undergoing PSG for suspected OSA were enrolled at three sleep laboratories. The chest-worn HSAT was used during overnight, level I PSG. Manually scored PSG (AASM manual 3.0) parameters were compared to the chest-worn HSAT’s associated parameters for AHI requiring hypopneas with 4% oxygen desaturation (sAHI4%), AHI requiring hypopneas with 3% oxygen desaturations (sAHI3%), TST, and classification of moderate-to-severe OSA (AHI≥15). AF and premature ventricular complexes (PVC) were visually compared between ECG derived from PSG and chest-worn HSAT. Results Enrollment included 101 patients (47% male, age 52±18 years, BMI 32±9 kg/m2, 27% Fitzpatrick skin tone 5-6). The chest-worn HSAT detected moderate-to-severe OSA with 90% sensitivity and 92% specificity (AHI4%, 37% prevalence) and 88% sensitivity and 80% specificity (AHI3%, 45% prevalence). Strong agreement was demonstrated for sAHI4% (-15.9 to 14.5 95% limits of agreement, LoA), sAHI3% (-23.6 to 20.7 95%-LoA), and TST (-62.0 to 87.7 95%-LoA). Preliminary visual review of ECG showed AF and/or PVCs in at least 15% of overnight recordings, in agreement with corresponding PSG ECG. Conclusion Non-flow-based HSATs to assess OSA are increasingly available; however, here we present the performance of a novel device to simultaneously diagnose OSA and AF (and other arrhythmias). Given the relevance of OSA treatment in successful AF management, these data highlight the capacity of a single point of contact chest-worn HSAT in the simultaneous diagnosis of both disorders toward downstream benefits of hastening OSA treatment to improve AF outcomes. Support (if any) National Science Foundation; Georgia Research Alliance; Huxley Medical, Inc.