Adaptive Servo Ventilation Improves not only Sympathetic Function but also Physical Performance: Results from New Multifunction Wireless Holter ECG

Abstract

Sympathetic activation plays a critical role of Cheyne-Stokes respiration (CSR) with chronic heart failure (CHF) and has associated with adverse clinical outcome. Recently, several studies have shown that adaptive servo ventilation (ASV) therapy improves the prognosis of CHF patients with CSR. However, it remains unclear the effect of ASV on sympathetic nervous activity. A case is a 50’s dilated cardiomyopathy man. He was diagnosed as severe CSR by polysomnography and treated with ASV. We performed new multifunction wireless holter ECG (CarPodR) before and after ASV therapy, which is able to evaluate the heart rate variability, physical activity, body temperature and etc. ASV improved apnea hypopnea index (63.8/h to 12.1/h) and slow wave sleep (2.3% to 3.4%). In addition, ASV decreased the occurrence of PVC (0.07% to 0.04%), LF/HF (2.7 to 1.3 during sleeping, 5.2 to 4.2 during awaking) and heart rate increase index (33.9 to 15.3), and also increased physical activity in the daytime. These results obtained from new multifunction wireless holter ECG suggest that ASV might improve not only sympathetic function but also physical performance in CHF patients with CSR.