Adaptive Servo-Ventilation Therapy Is the Most Effective Therapy for the Sleep Disorderd Breathing in Patients for Cardiac Resynchronization Therapy Candidates

Abstract

Introduction: The high incidence of sleep disorderd breathing (SDB) in patients with congestive heart failure (CHF) is well known. We compared adaptive pressure support servo-ventilation therapy (ASV) with nocturnal oxygen therapy (N-HOT) in patient with SDB from the cardiac resynchronization therapy (CRT) candidates. Methods: Thirty patients (22 men; 69.6±8.5 years old; mean left ventricular ejection fraction 32.6±9.9%) with SDB (apnea-hypopnea index (AHI)>15) who were scheduled for CRT therapy were studied. All patients received polysomnographic evaluations before CRT therapy. After implantation of a biventricular pacemaker, patients received ASV or N-HOT therapy (non-randomised). Cardiac events (cardiac death, and hospitalization due to congestive heart failure) were analysed retrospectively. Results: Mean follow up period was 790±561 day. Mean AHI of all patients was 26.4±10.8. Kaplan-Meier survival analysis showed that there was a significant difference between ASV and N-HOT in cardiac death, and hospitalisation due to congestive heart failure event (P=0.0283). There were no significant differences between ASV and N-HOT in patients’ baseline characteristics. Conclusions: ASV is superior to N-HOT for the SDB in patients who are CRT candidates.