Objective

Central sleep apnea (CSA) is associated with increased morbidity and mortality in patients with heart failure (HF). We aimed to explore the effectiveness of phrenic nerve stimulation (PNS) on CSA in patients with HF.

Methods

This was a prospective and non-randomized study. The stimulation lead was inserted into the right brachiocephalic vein and attached to a proprietary neurostimulator. Monitoring was conducted during the implantation process, and all individuals underwent two-night polysomnography.

Results

A total of nine subjects with HF and CSA were enrolled in our center. There was a significant decrease in the apnea–hypopnea index (41 ± 18 vs 29 ± 25, p = 0.02) and an increase in mean arterial oxygen saturation (SaO2) (93% ± 1% vs 95% ± 2%, p = 0.03) after PNS treatment. We did not observe any significant differences of oxygen desaturation index (ODI) and SaO2 < 90% (T90) following PNS. Unilateral phrenic nerve stimulation might also categorically improve the severity of sleep apnea.

Conclusion

In our non-randomized study, PNS may serve as a therapeutic approach for CSA in patients with HF.

中文翻译：

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膈神经刺激治疗心力衰竭患者中枢性睡眠呼吸暂停

客观的

中枢性睡眠呼吸暂停 (CSA) 与心力衰竭 (HF) 患者的发病率和死亡率增加有关。我们旨在探讨膈神经刺激 (PNS) 对 HF 患者 CSA 的有效性。

方法

这是一项前瞻性和非随机研究。将刺激导线插入右头臂静脉并连接到专有的神经刺激器。在植入过程中进行了监测，所有个体都接受了两晚的多导睡眠监测。

结果

我们中心共招收了 9 名患有 HF 和 CSA 的受试者。呼吸暂停低通气指数显着下降（41 ± 18 vs 29 ± 25，p  = 0.02），平均动脉血氧饱和度 (SaO2) 增加（93% ± 1% vs 95% ± 2%，p  = 0.03) PNS 治疗后。我们没有观察到 PNS 后氧饱和度指数 (ODI) 和 SaO2 < 90% (T90) 的任何显着差异。单侧膈神经刺激也可能明确改善睡眠呼吸暂停的严重程度。

结论

在我们的非随机研究中，PNS 可作为 HF 患者 CSA 的治疗方法。