Role of obstructive sleep apnea on the response to cardiac resynchronization therapy and all-cause mortality

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Ghanshyam ShanthaMichael Giudici

Abstract

The role of obstructive sleep apnea (OSA) on the response to cardiac resynchronization therapy (CRT) and all-cause mortality in patients with advanced heart failure (HF) is unknown. We assessed the association between OSA, response to CRT, and all-cause mortality in patients with HF. We analyzed records of 548 consecutive patients (mean age 65 ± 13 years; 216 (39%) women; mean follow-up period 76 ± 17 months) who received a CRT-defibrillator device from January 15, 2007 to March 30, 2016 at our tertiary care referral center. A total of 180 patients (33%) had OSA. Fewer patients in the OSA group (109 [61%]) had improvement in left ventricular ejection fraction (EF) than did those in the non-OSA group (253 [69%]) (P = .001). A total of 144 patients (27%) died by the end of follow-up (OSA group: 61 [33%]; non-OSA group 83 [23%]; P < .001). OSA diagnosis was associated with a lower chance of improvement in EF (hazard ratio 0.71; 95% confidence interval 0.60-0.89) and a higher risk of all-cause mortality (hazard ratio 3.7; 95% confidence interval 2.5-6.8). This was true in continuous positive airway pressure-compliant patients and in patients with nonischemic cardiomyopathy. However, among patients with ischemic cardiomyopathy, the ...Continue Reading

Citations

Aug 30, 2019·Arrhythmia & Electrophysiology Review·Ghanshyam ShanthaFred Morady
Oct 21, 2020·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·E A MedvedevaYu V Sviryaev
Jun 11, 2021·BMJ Open Respiratory Research·Emily S HeilbrunnAnna E Ssentongo

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