Improvement in Cheyne-Stokes respiration following cardiac resynchronisation therapy

• Published in: The European respiratory journal Vol. 26; no. 1; pp. 95 - 100
• Main Authors: Gabor, J. Y, Newman, D. A, Barnard-Roberts, V, Korley, V, Mangat, I, Dorian, P, Hanly, P. J
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01.07.2005; Maney
• Subjects: Aged; Analysis of Variance; Biological and medical sciences; Blood Gas Analysis; Cardiac Pacing, Artificial - methods; Cheyne-Stokes Respiration - diagnosis; Cheyne-Stokes Respiration - etiology; Chi-Square Distribution; Cohort Studies; Female; Follow-Up Studies; Heart Failure - complications; Heart Failure - diagnosis; Heart Failure - therapy; Heart Function Tests; Humans; Male; Medical sciences; Middle Aged; Monitoring, Physiologic - methods; Pneumology; Polysomnography - methods; Probability; Prospective Studies; Pulmonary Gas Exchange; Risk Assessment; Severity of Illness Index; Statistics, Nonparametric; Treatment Outcome; Cheyne-Stokes respiration; Instrumentation therapy; Instrumental stimulation; Cardiac resynchronisation therapy; Respiration
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.05.00093904

The effect of standard cardiac resynchronisation therapy (CRT) on the severity of Cheyne-Stokes respiration (CSR) in patients with congestive heart failure was studied. It was hypothesised that CRT, through its known beneficial effects on cardiac function, would stabilise the control of breathing and reduce CSR. Twenty-eight patients who were eligible for CRT and receiving optimised medical treatment for congestive heart failure were referred for overnight polysomnography, including monitoring of thoracic and abdominal movements to identify CSR and obstructive sleep apnoea events. Patients underwent repeat polysomnography after 6 months of CRT to re-evaluate sleep quality and sleep-disordered breathing. Twelve of the 28 patients had significant CSR (43%); 10 patients had a successful implantation and underwent repeat polysomnography a mean+/-SD 27+/-7 weeks after continuous biventricular pacing. Six of the 10 patients experienced a significant decrease in CSR severity following CRT, associated with correction of congestive heart failure-related hyperventilation and hypocapnia. Circulation time, oxygen saturation, frequency of obstructive apnoeas and sleep quality did not change. In conclusion, cardiac resynchronisation therapy is associated with a reduction in Cheyne-Stokes respiration, which may contribute to improved clinical outcome in patients treated with cardiac resynchronisation therapy.