Transvenous Phrenic Nerve Stimulation—A Novel Therapy for Central Sleep Apnea in Heart Failure

2012 ◽  
Vol 9 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Sitaramesh Emani ◽  
William T Abraham
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Treatment Options ◽  
Central Sleep Apnea ◽  
Phrenic Nerve Stimulation ◽  
Novel Therapy ◽  
Co Morbidity ◽  
Carbon Dioxide Levels

Central sleep apnea (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.

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.

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

scholarly journals Phrenic Nerve Stimulation Improves Physical Performance and Hypoxemia in Heart Failure Patients with Central Sleep Apnea

2021 ◽  
Vol 10 (2) ◽  
pp. 202
Author(s):  
Max Potratz ◽  
Christian Sohns ◽  
Daniel Dumitrescu ◽  
Philipp Sommer ◽  
Henrik Fox
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Physical Performance ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Central Sleep Apnea ◽  
Phrenic Nerve Stimulation ◽  
Performance Capacity ◽  
Physical Performance Capacity

Background: Central sleep apnea (CSA) is a common comorbidity in patients with heart failure (HF) and has been linked to increased morbidity and mortality risk. In addition, CSA is associated with impaired quality of life, reduced physical performance capacity, and hypoxemia. Phrenic nerve stimulation (PNS) is a novel approach to the treatment of CSA and has been shown to be safe and effective in this indication. However, there are currently no data on the effects of PNS on physical performance and hypoxia in CSA HF patients, both of which have been shown to be linked to mortality in HF. Methods: This prospective study enrolled patients with HF and CSA diagnosed using polysomnography. All were implanted with a PNS system (remedē® system, Respicardia Inc., Minnetonka, MN, USA) for the treatment of CSA. Examinations included polysomnography (to determine hypoxemic burden), echocardiography and a standardized 6-min walk test prior to device implantation (baseline) and after 6 months of follow-up. Results: A total of 24 patients were enrolled (mean age 67.1 ± 11.2 years, 88% male). The 6-min walk distance was 369.5 ± 163.5 m at baseline and significantly improved during follow-up (to 410 ± 169.7 m; p = 0.035). Hypoxemic burden, determined based on time with oxygen saturation < 90% improved from 81 ± 55.8 min at baseline to 27.9 ± 42.8 min during PNS therapy (p < 0.01). Conclusion: In addition to safely and effectively treating CSA, PNS is also associated with improved physical performance capacity and reduced hypoxemic burden in patients with HF.

Phrenic Nerve Stimulation Improves Circulatory Delay in Patients With Heart Failure and Central Sleep Apnea

2012 ◽  
Vol 18 (8) ◽  
pp. S14-S15
Author(s):  
William T. Abraham ◽  
Olaf Oldenburg ◽  
Piotr Ponikowski ◽  
Alan Schwartz ◽  
Bradley Bart ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Central Sleep Apnea ◽  
Phrenic Nerve Stimulation ◽  
Patients With Heart Failure

scholarly journals P588Effects of phrenic nerve stimulation on central sleep apnea in heart failure patients

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
M.R. Costanzo ◽  
P. Ponikowski ◽  
S. Javaheri ◽  
R. Augostini ◽  
L. Goldberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Central Sleep Apnea ◽  
Phrenic Nerve Stimulation ◽  
Heart Failure Patients

scholarly journals TRANSVENOUS PHRENIC NERVE STIMULATION IMPACT ON PATIENTS WITH HEART FAILURE AND CENTRAL SLEEP APNEA

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A2337
Author(s):  
Shahrokh Javaheri ◽  
Scott McKane ◽  
Timothy Meyer ◽  
Robin Germany ◽  
Lee Goldberg
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Central Sleep Apnea ◽  
Phrenic Nerve Stimulation ◽  
Patients With Heart Failure

scholarly journals 0711 Select Symptoms From The Epworth Sleepiness Scale Questionnaire And Response To Therapy Of Central Sleep Apnea With Phrenic Nerve Stimulation

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A270-A271
Author(s):  
S Javaheri ◽  
S McKane ◽  
T E Meyer ◽  
R Germany
Keyword(s):  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Controlled Trial ◽  
Central Sleep Apnea ◽  
Response To Therapy ◽  
Considerable Variability ◽  
Phrenic Nerve Stimulation ◽  
Randomized Controlled ◽  
Lying Down

Abstract Introduction Some subjects with central sleep apnea (CSA) complain of subjective excessive daytime sleepiness (EDS), as assessed by the Epworth Sleepiness Score (ESS). However, there is considerable variability in the level of chances of dozing for each of the 8 ESS questions, as each reflects a different situation. The aim of this analysis was to examine individual situations of the ESS and determine if transvenous phrenic nerve stimulation (TPNS) resulted in improvements of individual ESS situations which were scored moderate to high (2 and 3) at baseline. Patient Global Assessment (PGA) was also assessed. Methods All 151 subjects enrolled in the randomized (Treatment vs Control) remedē System pivotal trial were included in the analysis. All subjects were implanted, but activation in Control arm was delayed 6 months. Results Greater than or equal to 50% of patients scored moderate-high on several individual ESS situations: chance of dozing while sitting and reading (57%), watching television (62%), while lying down to rest in the afternoon when circumstances permit (76%). In the active arm, 68%, 44% and 29% of patients with moderate-high at baseline, respectively, for sitting and reading, watching television, and lying down to rest in the afternoon shifted to less than moderate at 6 months. Respective shifts for the control arm were 29%, 23% and 13%. Seventy-two percent of treated subjects with baseline ESS&gt;10 shifted to ≤10 at 6 months compared to 26% of control patients. Additionally, 72% of treated compared to 7% of control subjects with baseline ESS&gt;10 reported markedly or moderately improved QoL. Conclusion Results of this randomized controlled trial shows that compared to the control arm, TPNS leads to improvements in various situations of the ESS as well as QoL. The most improved situations were less chance of dozing while reading and watching television. Support Respicardia

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