Citation

Bordier P, Lataste A. Respir. Med. Case Rep. 2019; 26: 68-72.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.rmcr.2018.11.017

PMID

unavailable

Abstract

PURPOSE: The SERVE-HF study reported a risk of cardiovascular death associated with adaptive servo-ventilation (ASV) for central sleep apnea in patients with chronic heart failure with reduced left ventricular ejection fraction (LVEF). Therefore, we adopted in May 2015 a safety procedure in our 32 patients with ASV since 2006. It led to ASV removal in four patients due to ≤45% LVEF. At the end of the procedure we noted eight cases of death. This high 25% mortality rate led us to study these cases.

METHODS: The study population was derived from our database of patient follow-up from the sleep unit of our cardiovascular department.

RESULTS: All deceased patients but one had cardiac disorders but only one matched the SERVE-HF patient profile. ASV was due to predominant central (n = 4) or mixed (n = 4) sleep apnea. Six patients died prior to our procedure including two patients who died several months after ASV cessation, one from ventricular fibrillation and one from respiratory infection. The cases with ongoing ASV consisted in one case of end-stage heart failure with asystole, two cases of cancer and one case of suicide. Two patients died after their safety procedure with no contra-indications to ASV and before study completion in all the patients, one from cancer and one from pulmonary and renal disorders.

CONCLUSIONS: In this series, no relationship became apparent between sleep apnea or ASV and death. Cardiovascular deaths were not predominant. Further study will be required to clarify the risks associated with ASV in patients with cardiovascular disease. © 2018 The Authors

Language: en

Keywords

adult; human; suicide; female; male; aged; risk factor; clinical article; priority journal; middle aged; follow up; artificial ventilation; cardiovascular disease; heart ventricle fibrillation; Article; respiratory tract infection; sleep disordered breathing; Heart failure; very elderly; cardiovascular mortality; mortality rate; adaptive servo ventilation; Adaptive servo-ventilation; apnea hypopnea index; Hunter-Cheyne-Stokes breathing; safety procedure; Sleep apnea