Effect of atrial overdrive pacing on obstructive sleep apnea in patients with systolic heart failure

Sharafkhaneh, Amir; Sharafkhaneh, Hossein; Bredikus, Audrius; Guilleminault, Christian; Bozkurt, Biykem; Hirshkowitz, Max

doi:10.1016/j.sleep.2006.06.012

Cited by 39 publications

(39 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…258 Recent data confirm that despite a mild effect of atrial overdrive pacing on respiratory events in some heart failure patients with OSA, compared with CPAP, atrial overdrive pacing was not therapeutically effective in improving SDB. 259 There is currently no definitive evidence to support atrial overdrive pacing as a treatment option for OSA.…”

Section: Treatment Of Arrhythmias: Effects On Sleep Apneamentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

View full text Add to dashboard Cite

Section: Treatment Of Arrhythmias: Effects On Sleep Apneamentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

View full text Add to dashboard Cite

“…In previous studies, a single night of fixed overdrive atrial pacing lowered AHI significantly in recipients of conventional dual chamber pacemakers or cardioverter defibrillators with HF and predominant CSA, 1,21 whereas several months of dynamic overdrive atrial pacing had no effect on obstructive or mixed SA. 22,23 Furthermore, in patients with HF, CRT might alleviate CSA, while leaving obstructive respiratory events, if present, in the setting of HF.…”

Section: Discussionmentioning

confidence: 81%

“…In two other studies of overdrive atrial pacing in patients with HF without CRT, neither BNP nor SA were changed in one study, 37 while BNP was not measured and SA was alleviated in the other. 21 …”

Section: Discussionmentioning

confidence: 99%

“…Our observations are concordant with previous reports of a decrease in apneic events by cardiac pacing in patients with HF and predominant CSA. 1,[9][10][11][12]18,21 The impact of our experiment on apnea-related symptoms or on HF outcome has not been assessed. Patients with HF and CSA often have a paucity of symptoms related to central apnea.…”

Section: Statisticsmentioning

confidence: 99%

See 1 more Smart Citation

Overdrive Ventricular Pacing in Pacemaker Recipients with Permanent Atrial Fibrillation and Sleep Apnea

Bordier

Maurice-Tison

Ramana

2012

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: Cardiac pacing is ineffective in obstructive sleep apnea (SA), but it can alleviate central SA/CheyneStokes respiration (CSA) in patients with heart failure (HF). We examined whether overnight overdrive ventricular pacing (OVP) has an effect on SA in pacemaker recipients with permanent atrial fi brillation (AF). Methods: An apnea-hypopnea index (AHI) ≥ 15 was confi rmed in 28/38 patients screened by fi nger pulse oximetry during overnight ventricular pacing at a backup rate of 40 bpm (BUV40). These patients (23 men, 77.9 ± 7.6 y, BMI 27.6 ± 5.1 kg/m 2 ) were randomly assigned to 2 consecutive nocturnal ventilation polygraphies with BUV40 versus OVP at 20 bpm above the mean nocturnal heart rate observed during screening. Results: During BUV40 versus OVP, (1) mean heart rate was 49 ± 8 versus 71 ± 8 bpm (p < 0.0001) and percent ventricular pacing 36% ± 38% versus 96% ± 6% (p < 0.0001); (2) AHI was 35.4 ± 11.9 versus 32.5 ± 15.5 (p = ns), central AHI 23.9 ± 11.8 versus 19.1 ± 12.7 (p < 0.001), and obstructive AHI 11.6 ± 13.1 versus 13.5 ± 15.9 (p = ns). In 15/28 patients without HF, mean left ventricular ejection fraction (LVEF) was 51% ± 17%, AHI was 37.6 ± 11.0 during BUV40 and 39.0 ± 11.5 during OVP, versus 32.8 ± 12.9 and 24.9 ± 16.5 in 13/28 patients with HF (p = 0.02) and mean LVEF 35% ± 15% (p = 0.01). Between the 2 subgroups, (1) central AHI was 23.6 ± 12.4 during BUV40 and 21.5 ± 14.0 during OVP versus 24.1 ± 11.6 and 16.2 ± 10.7 (p = 0.05); (2) obstructive AHI was 14.0 ± 13.7 during BUV40 and 17.6 ± 16.5 during OVP versus 8.8 ± 12.3 and 8.7 ± 14.3 (p = ns). Conclusions:The prevalence of SA, predominantly central, was high in our pacemaker recipients with permanent AF. In those with HF, a single overnight OVP resulted in modest improvement in central events. keywords: Heart failure, sleep apnea, atrial fi brillation, cardiac pacing Citation: Bordier P; Maurice-Tison S; Ramana NK. Overdrive ventricular pacing in pacemaker recipients with permanent atrial fi brillation and sleep apnea. S C I E N T I F I C I N V E S T I g A T I O N SA fter a fi rst report suggesting that cardiac pacing might alleviate sleep apnea (SA), subsequent studies have yielded confl icting results.1,2 An increase in pacing rate by overdrive atrial pacing, using a dual chamber pacemaker implanted for the treatment of bradycardia, has no effect on obstructive SA (OSA) in patients without history of heart failure (HF). In contrast, cardiac resynchronization therapy (CRT) does alleviate central SA/Cheyne-Stokes respiration (CSA), a breathing disorder present in > 30% of patients with stable HF and associated with a decreased survival rate. 3-14The aim of this study was to compare the effects of overnight overdrive ventricular pacing (OVP) versus overnight ventricular pacing at a low backup rate on SA in recipients of permanent pacemakers suffering from permanent atrial fi brillation (AF). The comparison was also made in separating the patients depending on whether they suffered from HF or not. Those patients were chosen ...

show abstract

“…Three trials showed that CRT improves all types of apnoeic events significantly. In all these trials, CRT was also compared to atrial overpacing in a cross-over fashion [90,92,95].…”

Section: Recommendations On the Expert Consensus Levelmentioning

confidence: 99%

Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force

et al. 2016

View full text Add to dashboard Cite

Sleep disordered breathing (SDB) is a leading cause of morbidity worldwide. Its prevalence increases with age. Due to the demographic changes in industrial societies, pulmonologists and sleep physicians are confronted with a rapidly growing number of elderly SDB patients. For many physicians, it remains unclear how current guidelines for SDB management apply to elderly and frail elderly patients. The goal of this consensus statement is to provide guidance based on published evidence for SDB treatment in this specific patient group.Clinicians and researchers with expertise in geriatric sleep medicine representing several countries were invited to participate in a task force. A literature search of PubMed from the past 12 years and a systematic review of evidence of studies deemed relevant was performed.Recommendations for treatment management of elderly and frail elderly SDB patients based on published evidence were formulated via discussion and consensus.In the last 12 years, there have been surprisingly few studies examining treatment of SDB in older adults and even fewer in frail older adults. Studies that have been conducted on the management of SDB in the older patient population were rarely stratified for age. Studies in SDB treatment that did include age stratification mainly focused on middle-aged and younger patient groups. Based on the evidence that is available, this consensus statement highlights the treatment forms that can be recommended for elderly SDB patients and encourages treatment of SDB in this large patient group. @ERSpublications An overview of the research in the field of and clinical guidelines for the treatment of SDB in elderly patients

show abstract

Effect of atrial overdrive pacing on obstructive sleep apnea in patients with systolic heart failure

Cited by 39 publications

References 15 publications

Sleep Apnea and Cardiovascular Disease

Sleep Apnea and Cardiovascular Disease

Overdrive Ventricular Pacing in Pacemaker Recipients with Permanent Atrial Fibrillation and Sleep Apnea

Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force

Contact Info

Product

Resources

About