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1.
Heart Lung Circ ; 33(6): 828-881, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38702234

RESUMEN

Catheter ablation for atrial fibrillation (AF) has increased exponentially in many developed countries, including Australia and New Zealand. This Expert Position Statement on Catheter and Surgical Ablation for Atrial Fibrillation from the Cardiac Society of Australia and New Zealand (CSANZ) recognises healthcare factors, expertise and expenditure relevant to the Australian and New Zealand healthcare environments including considerations of potential implications for First Nations Peoples. The statement is cognisant of international advice but tailored to local conditions and populations, and is intended to be used by electrophysiologists, cardiologists and general physicians across all disciplines caring for patients with AF. They are also intended to provide guidance to healthcare facilities seeking to establish or maintain catheter ablation for AF.


Asunto(s)
Fibrilación Atrial , Ablación por Catéter , Sociedades Médicas , Fibrilación Atrial/cirugía , Humanos , Ablación por Catéter/métodos , Ablación por Catéter/normas , Nueva Zelanda , Australia , Cardiología/normas , Guías de Práctica Clínica como Asunto
3.
J Appl Physiol (1985) ; 92(5): 2114-8, 2002 May.
Artículo en Inglés | MEDLINE | ID: mdl-11960964

RESUMEN

We examined the initial effect of sleeping at a simulated moderate altitude of 2,650 m on the frequency of apneas and hypopneas, as well as on the heart rate and blood oxygen saturation from pulse oximetry (SpO2) during rapid eye movement (REM) and non-rapid eye movement (NREM) sleep of 17 trained cyclists. Pulse oximetry revealed that sleeping at simulated altitude significantly increased heart rate (3 +/- 1 beats/min; means +/- SE) and decreased SpO2 (-6 +/- 1%) compared with baseline data collected near sea level. In response to simulated altitude, 15 of the 17 subjects increased the combined frequency of apneas plus hypopneas from baseline levels. On exposure to simulated altitude, the increase in apnea was significant from baseline for both sleep states (2.0 +/- 1.3 events/h for REM, 9.9 +/- 6.2 events/h for NREM), but the difference between the two states was not significantly different. Hypopnea frequency was significantly elevated from baseline to simulated altitude exposure in both sleep states, and under hypoxic conditions it was greater in REM than in NREM sleep (7.9 +/- 1.8 vs. 4.2 +/- 1.3 events/h, respectively). Periodic breathing episodes during sleep were identified in four subjects, making this the first study to show periodic breathing in healthy adults at a level of hypoxia equivalent to 2,650-m altitude. These results indicate that simulated moderate hypoxia of a level typically chosen by coaches and elite athletes for simulated altitude programs can cause substantial respiratory events during sleep.


Asunto(s)
Hipoxia/fisiopatología , Periodicidad , Respiración , Síndromes de la Apnea del Sueño/fisiopatología , Sueño , Adulto , Altitud , Apnea/fisiopatología , Cámaras de Exposición Atmosférica , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Hipoxia/complicaciones , Masculino , Oximetría , Oxígeno/sangre , Aptitud Física , Polisomnografía , Sueño/fisiología , Síndromes de la Apnea del Sueño/etiología , Fases del Sueño
4.
J Clin Sleep Med ; 9(6): 559-66, 2013 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-23772189

RESUMEN

STUDY OBJECTIVES: To determine the relationship between sleep complaints, primary insomnia, excessive daytime sleepiness, and lifestyle factors in a large community-based sample. DESIGN: Cross-sectional study. SETTING: Blood donor sites in New Zealand. PATIENTS OR PARTICIPANTS: 22,389 individuals aged 16-84 years volunteering to donate blood. INTERVENTIONS: N/A. MEASUREMENTS: A comprehensive self-administered questionnaire including personal demographics and validated questions assessing sleep disorders (snoring, apnea), sleep complaints (sleep quantity, sleep dissatisfaction), insomnia symptoms, excessive daytime sleepiness, mood, and lifestyle factors such as work patterns, smoking, alcohol, and illicit substance use. Additionally, direct measurements of height and weight were obtained. RESULTS: One in three participants report < 7-8 h sleep, 5 or more nights per week, and 60% would like more sleep. Almost half the participants (45%) report suffering the symptoms of insomnia at least once per week, with one in 5 meeting more stringent criteria for primary insomnia. Excessive daytime sleepiness (evident in 9% of this large, predominantly healthy sample) was associated with insomnia (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.50 to 2.05), depression (OR 2.01, CI 1.74 to 2.32), and sleep disordered breathing (OR 1.92, CI 1.59 to 2.32). Long work hours, alcohol dependence, and rotating work shifts also increase the risk of daytime sleepiness. CONCLUSIONS: Even in this relatively young, healthy, non-clinical sample, sleep complaints and primary insomnia with subsequent excess daytime sleepiness were common. There were clear associations between many personal and lifestyle factors-such as depression, long work hours, alcohol dependence, and rotating shift work-and sleep problems or excessive daytime sleepiness.


Asunto(s)
Trastornos de Somnolencia Excesiva/epidemiología , Hábitos , Estilo de Vida , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Sueño , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Factores de Riesgo
6.
J Clin Sleep Med ; 3(3): 281-4, 2007 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-17561597

RESUMEN

OBJECTIVES: To describe the growth in the use of state-funded (Medicare) polysomnography (PSG) in Australia since 1990 and to compare PSG growth to other common diagnostic procedures and growth in total Medicare payments. METHODS: Interrogation of online database of historical census-level data routinely collected by Medicare. RESULTS: There has been a steady rise in the number of PSGs performed in Australia since 1990; the growth has been faster than overall Medicare-spending growth and faster than growth in comparable diagnostic procedures. However, there are marked interstate differences in growth. Per capita data, available only for 1995 to 2004, shows that nationwide PSG provision has risen from 123 to 308 per 100,000 people enrolled in Medicare. CONCLUSIONS: The provision of PSG in Australia has been growing steadily since publicly funded reimbursement began in 1990. This growth has been faster than the overall population growth and faster than the growth in Medicare funding for other diagnostic procedures and classes of medical interventions. However, the provision of PSG might be expected to continue to increase because the per capita provision (308 per 100,000) is still less than recent estimates from Canada and the United States (370.4 and 427.0 per 100,000, respectively).


Asunto(s)
Servicios de Salud/economía , Polisomnografía/estadística & datos numéricos , Polisomnografía/tendencias , Síndromes de la Apnea del Sueño/diagnóstico , Síndromes de la Apnea del Sueño/epidemiología , Adolescente , Adulto , Australia/epidemiología , Niño , Electroencefalografía/economía , Electroencefalografía/estadística & datos numéricos , Femenino , Costos de la Atención en Salud , Humanos , Lactante , Masculino , Polisomnografía/economía , Medicina Estatal/economía , Factores de Tiempo
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