Short-term Effects of Cardiac Resynchronization Therapy on Sleep-Disordered Breathing in Patients With Systolic Heart Failure

Kára, Tomáš; Novák, Miroslav; Nykodým, Jiří; Bybee, Kevin A.; Meluzı́n, Jaroslav; Orban, Marek; Nováková, Zuzana; Lipoldová, Jolana; Hayes, David L.; Soucek, M.; Vítovec, Jiří; Somers, Virend K.

doi:10.1378/chest.07-2832

Cited by 47 publications

(19 citation statements)

References 33 publications

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“…In another report of patients already on CRT, discontinuation of pacing resulted in increased CSA severity within 1 day, with attenuation of CSA on the following night when CRT was resumed. 374 Changes in CSA appeared to be associated with CRT-induced changes in mitral regurgitation. Further studies are required to confirm these early results, to determine the mechanism(s) by which CRT might improve CSA, and to identify which CSA patients with heart failure would benefit from such interventions.…”

Section: Treatment Options In Csamentioning

confidence: 97%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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Section: Treatment Options In Csamentioning

confidence: 97%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…[7][8][9][10][11] However, there is currently no information available on the effects of cardiac surgery on SAS in HF patients. In this study, we examined the relationships between HF with valvular heart diseases and OSA and CSA.…”

mentioning

confidence: 99%

Valve Repair Improves Central Sleep Apnea in Heart Failure Patients With Valvular Heart Diseases

Abe

Takahashi

Yaegashi

et al. 2009

Circ J

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“…Measurements of BNP have not been included in the majority of studies of CRT and sleep disordered breathing. [9][10][11][12]14 Lüthje et al observed a decrease in BNP after 3 months of CRT, of similar amplitude in patients with versus without CSA. 13 In that study, BNP was unchanged by overnight overdrive atrial pacing.…”

Section: Discussionmentioning

confidence: 89%

“…In contrast, cardiac resynchronization therapy (CRT) does alleviate central SA/Cheyne-Stokes respiration (CSA), a breathing disorder present in > 30% of patients with stable HF and associated with a decreased survival rate. [3][4][5][6][7][8][9][10][11][12][13][14] The aim of this study was to compare the effects of overnight overdrive ventricular pacing (OVP) versus overnight ventricular pacing at a low backup rate on SA in recipients of permanent pacemakers suffering from permanent atrial fi brillation (AF). The comparison was also made in separating the patients depending on whether they suffered from HF or not.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

“…Our observations are concordant with previous reports of a decrease in apneic events by cardiac pacing in patients with HF and predominant CSA. 1,[9][10][11][12]18,21 The impact of our experiment on apnea-related symptoms or on HF outcome has not been assessed. Patients with HF and CSA often have a paucity of symptoms related to central apnea.…”

Section: Statisticsmentioning

confidence: 99%

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Overdrive Ventricular Pacing in Pacemaker Recipients with Permanent Atrial Fibrillation and Sleep Apnea

Bordier

Maurice-Tison

Ramana

2012

Journal of Clinical Sleep Medicine

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Study Objectives: Cardiac pacing is ineffective in obstructive sleep apnea (SA), but it can alleviate central SA/CheyneStokes respiration (CSA) in patients with heart failure (HF). We examined whether overnight overdrive ventricular pacing (OVP) has an effect on SA in pacemaker recipients with permanent atrial fi brillation (AF). Methods: An apnea-hypopnea index (AHI) ≥ 15 was confi rmed in 28/38 patients screened by fi nger pulse oximetry during overnight ventricular pacing at a backup rate of 40 bpm (BUV40). These patients (23 men, 77.9 ± 7.6 y, BMI 27.6 ± 5.1 kg/m 2 ) were randomly assigned to 2 consecutive nocturnal ventilation polygraphies with BUV40 versus OVP at 20 bpm above the mean nocturnal heart rate observed during screening. Results: During BUV40 versus OVP, (1) mean heart rate was 49 ± 8 versus 71 ± 8 bpm (p < 0.0001) and percent ventricular pacing 36% ± 38% versus 96% ± 6% (p < 0.0001); (2) AHI was 35.4 ± 11.9 versus 32.5 ± 15.5 (p = ns), central AHI 23.9 ± 11.8 versus 19.1 ± 12.7 (p < 0.001), and obstructive AHI 11.6 ± 13.1 versus 13.5 ± 15.9 (p = ns). In 15/28 patients without HF, mean left ventricular ejection fraction (LVEF) was 51% ± 17%, AHI was 37.6 ± 11.0 during BUV40 and 39.0 ± 11.5 during OVP, versus 32.8 ± 12.9 and 24.9 ± 16.5 in 13/28 patients with HF (p = 0.02) and mean LVEF 35% ± 15% (p = 0.01). Between the 2 subgroups, (1) central AHI was 23.6 ± 12.4 during BUV40 and 21.5 ± 14.0 during OVP versus 24.1 ± 11.6 and 16.2 ± 10.7 (p = 0.05); (2) obstructive AHI was 14.0 ± 13.7 during BUV40 and 17.6 ± 16.5 during OVP versus 8.8 ± 12.3 and 8.7 ± 14.3 (p = ns). Conclusions:The prevalence of SA, predominantly central, was high in our pacemaker recipients with permanent AF. In those with HF, a single overnight OVP resulted in modest improvement in central events. keywords: Heart failure, sleep apnea, atrial fi brillation, cardiac pacing Citation: Bordier P; Maurice-Tison S; Ramana NK. Overdrive ventricular pacing in pacemaker recipients with permanent atrial fi brillation and sleep apnea. S C I E N T I F I C I N V E S T I g A T I O N SA fter a fi rst report suggesting that cardiac pacing might alleviate sleep apnea (SA), subsequent studies have yielded confl icting results.1,2 An increase in pacing rate by overdrive atrial pacing, using a dual chamber pacemaker implanted for the treatment of bradycardia, has no effect on obstructive SA (OSA) in patients without history of heart failure (HF). In contrast, cardiac resynchronization therapy (CRT) does alleviate central SA/Cheyne-Stokes respiration (CSA), a breathing disorder present in > 30% of patients with stable HF and associated with a decreased survival rate. 3-14The aim of this study was to compare the effects of overnight overdrive ventricular pacing (OVP) versus overnight ventricular pacing at a low backup rate on SA in recipients of permanent pacemakers suffering from permanent atrial fi brillation (AF). The comparison was also made in separating the patients depending on whether they suffered from HF or not. Those patients were chosen ...

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Short-term Effects of Cardiac Resynchronization Therapy on Sleep-Disordered Breathing in Patients With Systolic Heart Failure

Cited by 47 publications

References 33 publications

Sleep Apnea and Cardiovascular Disease

Sleep Apnea and Cardiovascular Disease

Valve Repair Improves Central Sleep Apnea in Heart Failure Patients With Valvular Heart Diseases

Overdrive Ventricular Pacing in Pacemaker Recipients with Permanent Atrial Fibrillation and Sleep Apnea

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