scholarly journals Phrenic nerve stimulation to treat patients with central sleep apnoea and heart failure

2018 ◽  
Vol 20 (12) ◽  
pp. 1746-1754 ◽  
Author(s):  
Maria Rosa Costanzo ◽  
Piotr Ponikowski ◽  
Andrew Coats ◽  
Shahrokh Javaheri ◽  
Ralph Augostini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Sleep Apnoea ◽  
Phrenic Nerve Stimulation ◽  
Central Sleep Apnoea

scholarly journals Transvenous phrenic nerve stimulation for the treatment of central sleep apnoea in heart failure

2011 ◽  
Vol 33 (7) ◽  
pp. 889-894 ◽  
Author(s):  
P. Ponikowski ◽  
S. Javaheri ◽  
D. Michalkiewicz ◽  
B. A. Bart ◽  
D. Czarnecka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Sleep Apnoea ◽  
Phrenic Nerve Stimulation ◽  
Central Sleep Apnoea

Transvenous Phrenic Nerve Stimulation – A Novel Therapy for Central Sleep Apnoea in Heart Failure

2012 ◽  
Vol 8 (1) ◽  
pp. 44
Author(s):  
Sitaramesh Emani ◽  
William T Abraham ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Treatment Options ◽  
Sleep Apnoea ◽  
Phrenic Nerve Stimulation ◽  
Novel Therapy ◽  
Central Sleep Apnoea ◽  
Co Morbidity ◽  
Carbon Dioxide Levels

Central sleep apnoea (CSA) is a prominent co-morbidity in heart failure (HF) resulting from dysregulated neurological responses to abnormal carbon dioxide levels. The presence of CSA in HF has been linked with deleterious physiological changes and is associated with increased mortality, yet treatment options for CSA in HF are currently lacking. This article briefly reviews the mechanisms of CSA in HF as well as the available evidence on present therapies, and describes phrenic nerve stimulation as a potential novel therapeutic approach.

scholarly journals The Management of Co-Morbidities in Patients with Heart Failure – Central Sleep Apnoea

2017 ◽  
Vol 10 ◽  
Author(s):  
Andrew JS Coats ◽  
Louise G Shewan ◽  
William T Abraham
Keyword(s):  
Heart Failure ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Discrete Event ◽  
Sleep Apnoea ◽  
Response To Treatment ◽  
Phrenic Nerve Stimulation ◽  
Central Sleep Apnoea ◽  
Obstructive Sleep ◽  
Co Morbidity

Despite many therapeutic advances, heart failure (HF) remains challenging to treat and continues to be associated with high rates of morbidity and mortality. There is an ongoing need to identify co-morbidities that either contribute to the progression of heart failure or limit the therapeutic response to treatment. One area under active investigation is the treatment of central sleep apnoea (CSA). CSA has consistently been shown to be associated with a worse prognosis in HF patients. Thus, understanding how to diagnose and treat CSA is of paramount importance to the HF clinician. Without treatment, HF patients continue to be at risk for the devastating consequences of CSA. Prognosis is very poor with studies consistently demonstrating poor outcomes among HF patients with CSA. Over the course of the night, each discrete event contributes to increased nor- epinephrine levels and hypoxia which are associated with progressive heart failure and arrhythmias. Initial therapeutic options utilized therapies which were developed for obstructive sleep apnoea with limited success or even harm. ASV is now contraindicated in HF patients with an EF < 45% leaving only 2 potential treatment options: CPAP and transvenous phrenic nerve stimulation. Data from the recently presented (post ESC guidelines) trial on transvenous phrenic nerve stimulation demonstrated efficacy without the need for patient compliance or any safety concerns. It is expected that additional studies in CSA will continue to demonstrate the full impact of treating this important co-morbidity on patients with HF.

Transvenous Phrenic Nerve Stimulation Improves Central Sleep Apnea in Heart Failure Patients

2020 ◽  
Vol 26 (10) ◽  
pp. S67
Author(s):  
Lee R. Goldberg ◽  
Loreena Hill ◽  
Maria Rosa Costanzo ◽  
Ovidiu Chioncel ◽  
Mitja Lainscak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Central Sleep Apnea ◽  
Phrenic Nerve Stimulation ◽  
Heart Failure Patients

P6320Unilateral phrenic nerve stimulation improves functional capabilities in heart failure patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Potratz ◽  
K J Gutleben ◽  
V Rudolph ◽  
H Fox
Keyword(s):  
Heart Failure ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Central Sleep Apnea ◽  
Walking Distance ◽  
Phrenic Nerve Stimulation ◽  
Reduced Ejection Fraction ◽  
Novel Technique ◽  
Functional Capabilities ◽  
Respiratory Events

Abstract Introduction Central sleep apnea is highly common in heart failure (HF) patients and often appears as Cheyne-Stokes-respiration (CSR). Presence of CSR in HF has been clearly shown to connote worse prognosis and HF patients with CSR experience increased mortality. Since widely used adaptive servoventilation is now contraindicated in HF with reduced ejection fraction alternative approaches for CSR treatment are needed. Unilateral phrenic nerve stimulation (PNS) is a novel technique to treat CSR and has recently been demonstrated to be safe and effective in HF patients, resulting in its market approval. While PNS has been shown to sufficiently treat CSR nothing is known in regard to functional characteristics in PNS treated HF patients. Therefore, this study investigated standardized six-minute walk test (6MWT) before and during PNS treatment in HF patients assessing functional impact of PNS on HF. Methods We prospectively enrolled 25 HF patients that have been implanted with novel PNS, mean age 67.05±11.22 years, 88% male, showing effective PNS CSR treatment. Adjacent to determine PNS effectiveness on CSR treatment standardized 6MWT was conducted before, at 6 months and at 12 months after PNS implantation. Results 25 (100%) patients had CSR, introduced PNS significantly suppressed respiratory events from 118.33±96.35 before to 34.65±51.41 after PNS therapy onset (p=0.001). Regarding functional improvements 6MWT improved from initial 369.5±163.56 meters before PNS implantation to 410±169.71 meters after 12 months. Hereby, total walking distance increased by 49.5% ± 100.8% (p=0.035). Conclusion PNS treatment is not only a novel technique to allow CSR treatment in HF, but for the first time, we provide comprehensible data illustrating functional improvements in HF in 6MWT, implying significant enhancements in daily physical capability of HF CSR patients treated with PN.

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