Details

Autor(en) / Beteiligte

• Patel, SI
• Lyng, P
• Olson, E
• Parish, J
• Colaco, B
• Miller, B
• Krahn, L

Titel

0550 DESCRIPTION OF THE ADAPTIVE SERVO-VENTILATION SAFETY RECALL AT A SINGLE ACADEMIC CENTER

Ist Teil von

• Sleep (New York, N.Y.), 2017-04, Vol.40 (suppl_1), p.A205-A205

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2017

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Introduction: Adaptive servo-ventilation (ASV) is a PAP modality prescribed for central sleep apnea (CSA). A safety notice was issued in 2015 for patients with congestive heart failure (CHF; ejection fraction [EF] ≤ 45%) and CSA treated with ASV based on the SERVE-HF study that found a 2.5% absolute increased risk of annual cardiovascular mortality in CHF-CSA patients on ASV compared to controls. Physicians were advised to discontinue ASV in these patients. This project was designed to evaluate the long-term mortality for CHF-CSA patients prescribed ASV. Methods: After IRB approval, retrospective chart review was performed for CHF-CSA patients started on ASV 2006 -2015 at Mayo Clinic Arizona. Results: Of 305 patients prescribed ASV, 23 patients were identified with an EF ≤ 45% and CSA (defined by an apnea-hypopnea index [AHI] ≥ 15/hour with > 50% central events). Mean age was 81 ± 11 years (96% male). Mean EF was 32.6 ± 13%. Mean AHI was 51 ± 20/hour with a CAI of 34 ± 18/hour. Mean follow-up from initial sleep evaluation was 3 ± 0.5 years. 16 (70%) have died (Mean EF 31 ± 10% and AHI 51 ± 20)). Causes of death were CHF(6), cancer (2), and unknown (8). Two were on ASV at time of death, 1 had stopped ASV, and ASV status was unknown in the rest. Of the 7 survivors, 1 elected to convert to CPAP after the safety notice, 2 remained on ASV, and 4 had no follow-up but were on ASV at last contact. Mean EF for those alive was 37 ± 16% and AHI 48 ± 21. Conclusion: Our study shows a high mortality rate of 70% for patients with EF ≤ 45% and CSA prescribed ASV. Given the small number of patients, absence of a control group, and high age of our cohort, it is unclear whether ASV use was associated with death in our cohort. Support (If Any):