ArticleFrontiers in cardiovascular medicine2026
Validation and implementation of ambulatory obstructive sleep apnea polygraphy screening combined with wearable semi-continuous heart rhythm monitoring in patients with atrial fibrillation: a validation and a pilot study.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Obstructive sleep apnea (OSA) is a prevalent yet underdiagnosed risk factor in atrial fibrillation (AF) patients and may influence AF burden. Systematic OSA screening and long-term non-invasive heart rhythm monitoring to follow up on AF remain challenging in clinical practice. This study aimed to validate the NOX-T3s polygraphy (PG) device for OSA screening, and to evaluate the feasibility of a structured OSA screening pathway combined with semi-continuous heart rhythm monitoring for mapping AF recurrences and burden. Methods: In the NOX-T3s validation study, NOX-T3s performance was evaluated in 30 AF patients undergoing PSG, with simultaneous and consecutive home NOX-T3s recordings. In the NOXFib-AF pilot study, the NOX-T3s was used for ambulatory OSA screening in another 30 AF patients, followed by 31 days of semi-continuous rhythm monitoring (every 9 min) via a smartwatch linked to the FibriCheck algorithm and twice-daily spot-checks via the FibriCheck smartphone application. Presence of AF was indicated as ≥1 AF measurement, with episodes defined as consecutive AF measurements terminated by a sinus rhythm measurement. Patients who screened OSA-positive were referred for PSG. Patient comfort with the devices was assessed via questionnaires. Results: NOX-T3s demonstrated good diagnostic performance for detecting moderate-to-severe OSA (AUC 0.83 simultaneous; 0.80 home), with Apnea-Hypopnea Index (AHI) values comparable to PSG (simultaneous recording Conclusions: NOX-T3s with an AHI cut-off ≥11.1 events/h is a reliable home screening tool for moderate-to-severe OSA. NOX-T3s-based OSA screening combined with semi-continuous FibriCheck-based rhythm monitoring has proven feasible and acceptable in AF patients.
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