Ventricular arrhythmia in heart failure patients with reduced ejection fraction and central sleep apnoea
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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.
Original language | English |
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Article number | ARTN 00147-2021 |
Journal | ERJ Open Research |
Volume | 7 |
Issue number | 3 |
Number of pages | 11 |
ISSN | 2312-0541 |
DOIs | |
Publication status | Published - 2021 |
- ADAPTIVE SERVO-VENTILATION, CHEYNE-STOKES RESPIRATION, NOCTURNAL ARRHYTHMIAS, MORTALITY, ECTOPY, DEATH, RISK, HF, DYSFUNCTION, PREVALENCE
Research areas
ID: 286922940