Ventricular arrhythmia in heart failure patients with reduced ejection fraction and central sleep apnoea
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Ventricular arrhythmia in heart failure patients with reduced ejection fraction and central sleep apnoea. / Fisser, Christoph; Bureck, Jannis; Gall, Lara; Vaas, Victoria; Priefert, Jorg; Fredersdorf, Sabine; Zeman, Florian; Linz, Dominik; Wohrle, Holger; Tamisier, Renaud; Teschler, Helmut; Cowie, Martin R.; Arzt, Michael.
In: ERJ Open Research, Vol. 7, No. 3, ARTN 00147-2021, 2021.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Ventricular arrhythmia in heart failure patients with reduced ejection fraction and central sleep apnoea
AU - Fisser, Christoph
AU - Bureck, Jannis
AU - Gall, Lara
AU - Vaas, Victoria
AU - Priefert, Jorg
AU - Fredersdorf, Sabine
AU - Zeman, Florian
AU - Linz, Dominik
AU - Wohrle, Holger
AU - Tamisier, Renaud
AU - Teschler, Helmut
AU - Cowie, Martin R.
AU - Arzt, Michael
PY - 2021
Y1 - 2021
N2 - Cheyne-Stokes respiration (CSR) may trigger ventricular arrhythmia in patients with heart failure with reduced ejection fraction (HFrEF) and central sleep apnoea (CSA). This study determined the prevalence and predictors of a high nocturnal ventricular arrhythmia burden in patients with HFrEF and CSA (with and without CSR) and to evaluate the temporal association between CSR and the ventricular arrhythmia burden.This cross-sectional ancillary analysis included 239 participants from the SERVE-HF major sub-study who had HFrEF and CSA, and nocturnal ECG from polysomnography. CSR was stratified in >= 20% and 30 premature ventricular complexes (PVCs) per hour of TRT. A sub-analysis was performed to evaluate the temporal association between CSR and ventricular arrhythmias in sleep stage N2.High ventricular arrhythmia burden was observed in 44% of patients. In multivariate logistic regression analysis, male sex, lower systolic blood pressure, non-use of antiarrhythmic medication and CSR.20% were significantly associated with PVCs >30.h(-1) (OR 5.49, 95% CI 1.51-19.91, p=0.010; OR 0.98, 95% CI 0.97-1.00, p=0.017; OR 5.02, 95% CI 1.51- 19.91, p=0.001; and OR 2.22, 95% CI 1.22-4.05, p=0.009; respectively). PVCs occurred more frequently during sleep phases with versus without CSR (median (interquartile range): 64.6 (24.8-145.7) versus 34.6 (4.8-75.2).h(-1) N2 sleep; p=0.006).Further mechanistic studies and arrhythmia analysis of major randomised trials evaluating the effect of treating CSR on ventricular arrhythmia burden and arrhythmia-related outcomes are warranted to understand how these data match with the results of the parent SERVE-HF study.
AB - Cheyne-Stokes respiration (CSR) may trigger ventricular arrhythmia in patients with heart failure with reduced ejection fraction (HFrEF) and central sleep apnoea (CSA). This study determined the prevalence and predictors of a high nocturnal ventricular arrhythmia burden in patients with HFrEF and CSA (with and without CSR) and to evaluate the temporal association between CSR and the ventricular arrhythmia burden.This cross-sectional ancillary analysis included 239 participants from the SERVE-HF major sub-study who had HFrEF and CSA, and nocturnal ECG from polysomnography. CSR was stratified in >= 20% and 30 premature ventricular complexes (PVCs) per hour of TRT. A sub-analysis was performed to evaluate the temporal association between CSR and ventricular arrhythmias in sleep stage N2.High ventricular arrhythmia burden was observed in 44% of patients. In multivariate logistic regression analysis, male sex, lower systolic blood pressure, non-use of antiarrhythmic medication and CSR.20% were significantly associated with PVCs >30.h(-1) (OR 5.49, 95% CI 1.51-19.91, p=0.010; OR 0.98, 95% CI 0.97-1.00, p=0.017; OR 5.02, 95% CI 1.51- 19.91, p=0.001; and OR 2.22, 95% CI 1.22-4.05, p=0.009; respectively). PVCs occurred more frequently during sleep phases with versus without CSR (median (interquartile range): 64.6 (24.8-145.7) versus 34.6 (4.8-75.2).h(-1) N2 sleep; p=0.006).Further mechanistic studies and arrhythmia analysis of major randomised trials evaluating the effect of treating CSR on ventricular arrhythmia burden and arrhythmia-related outcomes are warranted to understand how these data match with the results of the parent SERVE-HF study.
KW - ADAPTIVE SERVO-VENTILATION
KW - CHEYNE-STOKES RESPIRATION
KW - NOCTURNAL ARRHYTHMIAS
KW - MORTALITY
KW - ECTOPY
KW - DEATH
KW - RISK
KW - HF
KW - DYSFUNCTION
KW - PREVALENCE
U2 - 10.1183/23120541.00147-2021
DO - 10.1183/23120541.00147-2021
M3 - Journal article
C2 - 34350283
VL - 7
JO - ERJ Open Research
JF - ERJ Open Research
SN - 2312-0541
IS - 3
M1 - ARTN 00147-2021
ER -
ID: 286922940