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Phrenic nerve stimulation to treat patients with central sleep apnoea and heart failure
Author(s) -
Costanzo Maria Rosa,
Ponikowski Piotr,
Coats Andrew,
Javaheri Shahrokh,
Augostini Ralph,
Goldberg Lee R.,
Holcomb Richard,
Kao Andrew,
Khayat Rami N.,
Oldenburg Olaf,
Stellbrink Christoph,
McKane Scott,
Abraham William T.
Publication year - 2018
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.1312
Subject(s) - medicine , heart failure , epworth sleepiness scale , quality of life (healthcare) , adverse effect , randomized controlled trial , anesthesia , cardiology , polysomnography , apnea , nursing
Aims The presence of central sleep apnoea (CSA) is associated with poor prognosis in patients with heart failure (HF). The aim of this analysis was to evaluate if using phrenic nerve stimulation to treat CSA in patients with CSA and HF was associated with changes in HF‐specific metrics. Methods and results All patients randomized in the rem edē System Pivotal Trial and identified at baseline with HF were included ( n = 96). Effectiveness data from treatment and former control groups were pooled based on months since therapy activation. Changes from baseline to 6 and 12 months in sleep metrics, Epworth Sleepiness Scale, patient global assessment health‐related quality of life, Minnesota Living with Heart Failure Questionnaire (MLHFQ), and echocardiographic parameters are reported. HF hospitalization, cardiovascular death, and the composite of HF hospitalization or cardiovascular death within 6 months are reported by the original randomized group assignment for safety assessment. Sleep metrics and quality of life improved from baseline to 6 and 12 months. At 12 months, MLHFQ scores changed by –6.8 ± 20.0 ( P = 0.005). The 6‐month rate of HF hospitalization was 4.7% in treatment patients (standard error = 3.3) and 17.0% in control patients (standard error = 5.5) ( P = 0.065). Reported adverse events were as expected for a transvenous implantable system. Conclusions Phrenic nerve stimulation reduces CSA severity in patients with HF. In parallel, this CSA treatment was associated with benefits on HF quality of life.