Abstract 16707: Cheyne-Stokes Respiration in Patients with Congestive Heart Failure: Association with Malignant Arrhythmic Events and Effects of Adaptive Servoventilation Therapy – an Observational Study
Background: In patients (pts) with chronic heart failure (CHF) Cheyne-Stokes respiration (CSR) is an independent predictor for the manifestation of malignant arrhythmias. Aim of this study was to investigate, whether treatment of CSR by Adaptive Servoventilation (ASV) reduces the risk of malignant arrhythmic events in pts with CHF and CSR.
Methods: Of 403 pts. with CHF (LVEF ≤ 45%, NYHA-class ≥ 2) and implanted CRT-D or ICD device, 221 pts presented with mild or no CSR (Apnea-Hypopnea-Index (AHI) <15/h), while 182 pts with moderate to severe CSR (AHI ≥ 15/h) were offered ASV treatment. An ongoing ASV therapy had already been initiated in 96 pts (Treated CSR). Additional 86 pts rejected treatment initially or withdrew treatment during follow-up (Untreated CSR). During follow-up (48 months) appropriately monitored ventricular arrhythmias as well as appropriate cardioverter-defibrillator therapies were analyzed.
Results: Kaplan-Meyer-Plot on event-free survival from appropriately monitored ventricular arrhythmias (Fig.1) and appropriate cardioverter-defibrillator therapies (Fig.2) as well as results from multiple COX proportional hazard regression analysis (,,backward selection“ with AIC), adjusted for all significant cofactors are shown below.
Conclusions: ASV therapy reduces the risk of malignant arrhythmic events in CHF pts with CHF and moderate to severe CSR. Mechanisms involved as well as implications on total mortality need to be determined.
- © 2010 by American Heart Association, Inc.