Effects of Adaptive Servo-Ventilation on Nocturnal Ventricular Arrhythmia in Heart Failure Patients With Reduced Ejection Fraction and Central Sleep Apnea–An Analysis From the SERVE-HF Major Substudy
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Background: The SERVE-HF trial investigated the effect of treating central sleep apnoea (CSA) with adaptive servo-ventilation (ASV) in patients with heart failure with reduced ejection fraction (HFrEF). Objective: The aim of the present ancillary analysis of the SERVE-HF major substudy (NCT01164592) was to assess the effects of ASV on the burden of nocturnal ventricular arrhythmias as one possible mechanism for sudden cardiac death in ASV-treated patients with HFrEF and CSA. Methods: Three hundred twelve patients were randomized in the SERVE-HF major substudy [no treatment of CSA (control) vs. ASV]. Polysomnography including nocturnal ECG fulfilling technical requirements was performed at baseline, and at 3 and 12 months. Premature ventricular complexes (events/h of total recording time) and non-sustained ventricular tachycardia were assessed. Linear mixed models and generalized linear mixed models were used to analyse differences between the control and ASV groups, and changes over time. Results: From baseline to 3- and 12-month follow-up, respectively, the number of premature ventricular complexes (control: median 19.7, 19.0 and 19.0; ASV: 29.1, 29.0 and 26.0 events/h; p = 0.800) and the occurrence of ≥1 non-sustained ventricular tachycardia/night (control: 18, 25, and 18% of patients; ASV: 24, 16, and 24% of patients; p = 0.095) were similar in the control and ASV groups. Conclusion: Addition of ASV to guideline-based medical management had no significant effect on nocturnal ventricular ectopy or tachyarrhythmia over a period of 12 months in alive patients with HFrEF and CSA. Findings do not further support the hypothesis that ASV may lead to sudden cardiac death by triggering ventricular tachyarrhythmia.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 896917 |
| Tidsskrift | Frontiers in Cardiovascular Medicine |
| Vol/bind | 9 |
| Antal sider | 10 |
| ISSN | 2297-055X |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
The SERVE-HF trial was supported by ResMed and by grants from the National Institute for Health Research (NIHR) Cardiovascular and Respiratory Biomedical Research Units (general award to the hospital; MC). Representatives and scientists from the ResMed participated in the study including design and data collection. This ancillary analysis was supported by ResMed (MA) and by a grant from the German Heart Foundation/German Foundation of Heart Research (F/15/20; CF).
Funding Information:
CF reports receiving support from the German Heart Foundation/German Foundation of Heart Research. VV received grant support from the German Society of Sleep Medicine. On behalf of DL, the University of Maastricht has received lecture fees and/or consulting fees and/or research grants from Bayer, LivaNova, ResMed and Respicardia. HW was a former employee of ResMed during the SERVE-HF study. RT has received consulting fees from Agiradom (Healthcare provider) and grant support from ResMed. MC has received consulting fees from ResMed and Respicardia, and grant support through his Institution from ResMed, Bayer and Abbott. HT has received consulting fees, grant support, and hardware and software for the development of devices from ResMed. MA has received consulting fees from ResMed, Philips Respironics, Boehringer-Ingelheim, NRI, Novartis, JAZZ Pharmaceuticals, Bayer, Inspire and Bresotec,and grant support from ResMed Foundation, Philips Respironics and the Else-Kroener Fresenius Foundation (2018_A159) outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Funding Information:
The authors thank the CRI (Clinical Research Institute) for their expertise in overseeing the SERVE-HF trial. Medical writing assistance was provided by Nicola Ryan, independent medical writer, funded by ResMed.
Publisher Copyright:
Copyright © 2022 Fisser, Gall, Bureck, Vaas, Priefert, Fredersdorf, Zeman, Linz, Woehrle, Tamisier, Teschler, Cowie and Arzt.
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