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- Title
Effekte einer adaptiven Servoventilation auf Herzrhythmusstörungen bei Patienten mit chronischer Herzinsuffizienz und schlafbezogenen Atmungsstörungen.
- Authors
Priefert, Hans-Jörg; Hetzenecker, Andrea; Escourrou, Pierre; Luigart, Ruth; Series, Frédéric; Lewis, Keir; Benjamin, Amit; Birner, Christoph; Pfeifer, Michael; Arzt, Michael
- Abstract
Background: In patients with chronic heart failure with reduced left ventricular ejection fraction (HFrEF) sleep-disordered breathing (SDB) is linked with an increased risk for nocturnal cardiac arrhythmias. SDB can be effectively treated with adaptive servo-ventilation (ASV). Therefore, we tested the hypothesis that ASV therapy reduces nocturnal arrhythmias and heart rate in patients with HFrEF and SDB. Methods: In a non-prespecified subanalysis of a multicenter randomized-controlled trial (ISRCTN04353156) twenty consecutive patients with stable HFrEF (age 67 ± 9 y; left ventricular ejection fraction 32 ± 7 %) and SDB (apnea-hypopnea index, AHI 48 ± 20/h) were randomized to either ASV ( n = 10; Philips Respironics, Murrysville, PA, USA) or optimal medical treatment alone (control, n = 10). Polysomnography (PSG) with centralized scoring and blinded analysis where obtained at baseline and 12 weeks. The electrocardiograms (ECG) of the PSGs were analyzed with 24 h-Holter electrocardiography software (Pulse Biomedical Inc., QRS-Card Cardiology Suite, USA). Results: There was a decrease in ventricular ectopic beats (VEBs) per hour recording time in the ASV-group compared to the control group (−8.1 ± 42.4 versus +9.8 ± 63.7/h, p = 0.356). ASV reduced the number of ventricular couplets as well as non-sustained ventricular tachycardias (nsVT) compared to the control-group (−2.3 ± 6.9 versus +2.1 ± 12.7/h, p = 0.272, and −0.1 ± 0.5 versus +0.1 ± 1.1/h, p = 0.407, respectively). Mean nocturnal heart rate decreased in the ASV group compared to the control-group (−2.0 ± 2.7 versus +3.9 ± 11.5/minute, p = 0,169). Described changes were not significantly different between groups. Conclusions: In HFrEF patients with SDB ASV treatment may reduce nocturnal ventricular ectopic beats, couplets, nsVT and mean nocturnal heart rate. Findings underscore the need for further analyses in larger studies.
- Publication
Somnologie, 2016, Vol 20, Issue 2, p96
- ISSN
1432-9123
- Publication type
Article
- DOI
10.1007/s11818-016-0059-3