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Adaptive servo-ventilation

Teruhiko Imamura, Daisuke Nitta, Koichiro Kinugawa
BACKGROUND: Adaptive servo-ventilation (ASV) therapy is a recent non-invasive positive pressure ventilation therapy that was developed for patients with heart failure (HF) refractory to optimal medical therapy. However, it is likely that ASV therapy at relatively higher pressure setting worsens some of the patients' prognosis compared with optimal medical therapy. Therefore, identification of optimal pressure settings of ASV therapy is warranted. CASE PRESENTATION: We present the case of a 42-year-old male with HF, which was caused by dilated cardiomyopathy, who was admitted to our institution for evaluating his eligibility for heart transplantation...
January 5, 2017: BMC Cardiovascular Disorders
Jong Hun Kim, Kyung Hwa Kim, Jong Bum Choi, Ja Hong Kuh
Letter to the Editor We read with great interest the report by Inoue et al. (Cusp-level chordal shortening for non-rheumatic mitralanterior leaflet prolapse in a patient with persistent atrial fibrillation. J Heart Valve Dis 2015;24:586-589) that described their mitral valve repair technique for anterior leaflet prolapse (ALP) and perioperative adaptive servo-ventilation (ASV) therapy for preventing the recurrence of atrial fibrillation after the maze procedure. Latent recurrence of atrial fibrillation after the maze procedure is caused by many factors...
July 2016: Journal of Heart Valve Disease
Paul D Callan, Andrew L Clark
Physicians responsible for the care of patients with heart failure due to left ventricular systolic dysfunction have access to a broad range of evidence-based treatments that prolong life and reduce symptoms. In spite of the significant progress made over the last four decades, there is an ongoing need for novel therapies to treat a condition that is associated with stubbornly high morbidity and mortality. In this article, we discuss the findings of SERVE-HF, a randomised controlled trial of adaptive servo-ventilation in patients with left ventricular systolic dysfunction, as well as EMPA-REG, a study of the effects of a novel diabetic agent that may be of greater interest to heart failure specialists than diabetologists...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Arild Hetland, Kristina H Haugaa, Maria Vistnes, Kristian Hovde Liland, Margareth Olseng, Morten B Jacobsen, Thor Edvardsen
OBJECTIVES: The effect of long-term adaptive servo-ventilation (ASV) on cardiovascular mortality and admission rates in patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) has not been much studied. The aim of this study was primarily to investigate whether ASV therapy significantly reduced these parameters. DESIGN: We included 75 CHF patients on optimal medication and CSR ≥25% of sleeping time, in New York Heart Association (NYHA) classes II-IV and left ventricular ejection fraction (LVEF) ≤ 45%...
December 7, 2016: Scandinavian Cardiovascular Journal: SCJ
Barry Krakow, Victor A Ulibarri, Natalia D McIver, Michael R Nadorff
Objective: Evidence indicates that behavioral or drug therapy may not target underlying pathophysiologic mechanisms for chronic insomnia, possibly due to previously unrecognized high rates (30%-90%) of sleep apnea in chronic insomnia patients. Although treatment studies with positive airway pressure (PAP) demonstrate decreased severity of chronic sleep maintenance insomnia in patients with co-occurring sleep apnea, sleep-onset insomnia has not shown similar results. We hypothesized advanced PAP technology would be associated with decreased sleep-onset insomnia severity in a sample of predominantly psychiatric patients with comorbid sleep apnea...
September 29, 2016: Primary Care Companion to CNS Disorders
Syed Basharath Mehdi, Salem Madi, Jordan Sudworth
Trans-diaphragmatic intercostal hernia is a rare entity. Patient with multiple medical comorbidities, including obstructive sleep apnoea, presents with shortness of breath, leg oedema and a bulging swelling through the right chest wall. CT shows partial herniation of the right lung and liver through intercostal space and an echocardiogram reveals right heart failure. He was treated initially with continuous positive airway pressure with poor response and subsequently treated with adaptive servo ventilation with much better symptomatic relief and treatment tolerance...
October 28, 2016: BMJ Case Reports
Masataka Kamiya, Morio Kamiya, Masami Tsuzuki, Toshiro Tanaka, Makoto Saitoh
No abstract text is available yet for this article.
September 13, 2016: International Journal of Cardiology
Arudo Hiraoka, Kota Suzuki, Genta Chikazawa, Shinsaku Nogami, Taichi Sakaguchi, Hidenori Yoshitaka
OBJECTIVES: The aim of this prospective, randomized study was to investigate the effects of adaptive servo-ventilation (ASV), based on haemodynamic parameters, sympathetic status and respiratory conditions in patients with acute uncomplicated type B aortic dissection. METHODS: We enrolled 28 patients with acute uncomplicated type B aortic dissection requiring antihypertensive therapies, who had been admitted within 24 h from onset. Study subjects were randomly assigned either to the ASV group (n = 14) or to the non-ASV group (n = 14)...
September 7, 2016: Interactive Cardiovascular and Thoracic Surgery
R Nisha Aurora, Sabin R Bista, Kenneth R Casey, Susmita Chowdhuri, David A Kristo, Jorge M Mallea, Kannan Ramar, James A Rowley, Rochelle S Zak, Jonathan L Heald
No abstract text is available yet for this article.
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Bernardo Selim, Kannan Ramar
INTRODUCTION: Volume assured pressure support (VAPS) and adaptive servo ventilation (ASV) are non-invasive positive airway pressure (PAP) modes with sophisticated negative feedback control systems (servomechanism), having the capability to self-adjust in real time its respiratory controlled variables to patient's respiratory fluctuations. However, the widespread use of VAPS and ASV is limited by scant clinical experience, high costs, and the incomplete understanding of propriety algorithmic differences in devices' response to patient's respiratory changes...
September 2016: Expert Review of Medical Devices
Jing Cheng, Yanping Liu, Guishuang Li, Zhongwen Zhang, Lianyue Ma, Xiaoyan Yang, Jianmin Yang, Kai Zhang, Jing Kong, Mei Dong, Meng Zhang, Xingli Xu, Wenhai Sui, Jiali Wang, Rui Shang, Xiaoping Ji, Yun Zhang, Cheng Zhang, Panpan Hao
Chronic heart failure (CHF) has been shown to be associated with an increased incidence of sleep-disordered breathing. Whether treatment with noninvasivepositive-pressure ventilation (NPPV), including continuous positive airway pressure, bi-level positive airway pressure and adaptive servo-ventilation, improves clinical outcomes of CHF patients is still debated. 2,832 CHF patients were enrolled in our analysis. NPPV was significantly associated with improvement in left ventricular ejection fraction (39.39% vs...
August 2, 2016: Oncotarget
Takuji Toyama, Hiroshi Hoshizaki, Shu Kasama, Yusuke Miyaishi, Hakuken Kan, Eiji Yamashita, Ren Kawaguti, Hitoshi Adachi, Shigeru Ohsima
PURPOSE: Adaptive servo-ventilation (ASV) therapy has been reported to be effective for improving central sleep apnea (CSA) and chronic heart failure (CHF). The purpose of this study was to clarify whether ASV is effective for CSA, cardiac sympathetic nerve activity (CSNA), cardiac symptoms/function, and exercise capacity in CHF patients with CSA and Cheyne-Stokes respiration (CSR-CSA). METHODS: In this study, 31 CHF patients with CSR-CSA and a left ventricular ejection fraction (LVEF) ≤ 40% were randomized into an ASV group and a conservative therapy (non-ASV) group for 6 month...
July 7, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Teruhiko Imamura, Koichiro Kinugawa, Daisuke Nitta, Issei Komuro
Adaptive servo-ventilation support and Waon therapy are recently developed non-pharmacological and noninvasive therapies for patients with heart failure refractory to guideline-directed medical therapy. These therapies decrease both preload and afterload, increase cardiac output, and appear to ameliorate autonomic nerve activity. However, the time course of autonomic nerve activity during these therapies remains unclear. We performed heart rate variability analysis using the MemCalc power spectral density method (MemCalc system; Suwa Trust Co, Tokyo) to assess autonomic nerve activity during adaptive servo-ventilation support and Waon therapy in two different cases and determined the time course of autonomic nerve activity during these therapies...
July 27, 2016: International Heart Journal
Masaki Kinoshita, Hideki Okayama, Go Kawamura, Tatsuya Shigematsu, Tatsunori Takahashi, Yoshitaka Kawata, Go Hiasa, Tadakatsu Yamada, Yukio Kazatani
BACKGROUND: Adaptive servo-ventilation (ASV) at home has been used for patients with chronic heart failure. However, its effect on acute cardiogenic pulmonary edema (ACPE) is not clear. The aim of this study was to elucidate the effect of ASV use in the emergency room in patients with ACPE. METHODS: We enrolled 198 consecutive patients with ACPE. Eighty patients received standard therapies, such as oxygen inhalation and vasodilators (conventional therapy group), and 118 received ASV in addition to standard therapy (ASV therapy group)...
January 2017: Journal of Cardiology
Margareth W Olseng, Brita F Olsen, Arild Hetland, May S Fagermoen, Morten Jacobsen
AIMS AND OBJECTIVES: The aim of this study was to investigate if quality of life improved in chronic heart failure patients with Cheyne-Stokes respiration treated with adaptive servo-ventilation in nurse-led heart failure clinic. BACKGROUND: Cheyne-Stokes respiration is associated with decreased quality of life in patients with chronic heart failure. Adaptive servo-ventilation is introduced to treat this sleep-disordered breathing. DESIGN: Randomized, controlled design...
June 6, 2016: Journal of Clinical Nursing
Emer Van Ryswyk, Nick A Antic
Opioid use for chronic pain analgesia, particularly chronic noncancer pain, has increased greatly since the late 1990s, resulting in an increase in opioid-associated morbidity and mortality. A clear link between opioid use and sleep-disordered breathing (SDB) has been established, with the majority of chronic opioid users being affected by the condition, and dose-dependent severity apparent for some opioids. More evidence is currently needed on how to effectively manage opioid-induced SDB. This review summarizes the current state of knowledge relating to management of patients undergoing chronic opioid therapy who have SDB...
October 2016: Chest
Nobuhiko Haruki, Wendy Tsang, Paaladinesh Thavendiranathan, Anna Woo, George Tomlinson, Alexander G Logan, T Douglas Bradley, John S Floras
BACKGROUND: The study aim was to determine whether phasic left atrial (LA) function of patients with heart failure with reduced ejection fraction differs between those with obstructive sleep apnea (OSA) and central sleep apnea (CSA). METHODS: Participation in the Adaptive Servo Ventilation for Therapy of Sleep Apnea in Heart Failure (ADVENT-HF) trial requires 2-dimensional echocardiographic documentation of left ventricular ejection fraction ≤ 45% and a polysomnographic apnea hypopnea index (AHI) ≥ 15 events per hour...
February 13, 2016: Canadian Journal of Cardiology
Pierre-Yves Olivier, Marie Joyeux-Faure, Thibaut Gentina, Sandrine H Launois, Marie Pia d'Ortho, Jean-Louis Pépin, Frédéric Gagnadoux
Baclofen, a gamma-aminobutyric acid-B agonist with muscle-relaxant properties, is widely used in patients with severe spasticity. In animals, baclofen has been shown to decrease respiratory drive. In humans, however, use of baclofen at the standard dose did not significantly impair sleep-disordered breathing in a susceptible population of snorers. Recently, there has been increasing interest in the role of baclofen for the treatment of alcohol dependence. We describe severe central sleep apnea (CSA) in four patients with none of the conditions commonly associated with CSA who were receiving chronic baclofen therapy for alcohol withdrawal...
May 2016: Chest
R Nisha Aurora, Sabin R Bista, Kenneth R Casey, Susmita Chowdhuri, David A Kristo, Jorge M Mallea, Kannan Ramar, James A Rowley, Rochelle S Zak, Jonathan L Heald
An update of the 2012 systematic review and meta-analyses were performed and a modified-GRADE approach was used to update the recommendation for the use of adaptive servo-ventilation (ASV) for the treatment of central sleep apnea syndrome (CSAS) related to congestive heart failure (CHF). Meta-analyses demonstrated an improvement in LVEF and a normalization of AHI in all patients. Analyses also demonstrated an increased risk of cardiac mortality in patients with an LVEF of ≤ 45% and moderate or severe CSA predominant sleep-disordered breathing...
May 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Hyunju Yang, Amy M Sawyer
To summarize the current evidence for adaptive servo ventilation (ASV) in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF) and advance a research agenda and clinical considerations for ASV-treated CSR-CSA in HF. CSR-CSA in HF is associated with higher overall mortality, worse outcomes and lower quality of life (QOL) than HF without CSR-CSA. Five databases were searched using key words (n = 234). Randomized controlled trials assessed objective sleep quality, cardiac, and self-reported outcomes in adults (≥18 years) with HF (n = 10)...
May 2016: Heart & Lung: the Journal of Critical Care
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