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Impact of sleep-disordered breathing on ventricular tachyarrhythmias after left ventricular assist device implantation

  • Original Article
  • Artificial Heart (Clinical)
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Abstract

Sleep-disordered breathing (SDB) is associated with an increased risk of adverse events in patients with heart failure (HF); however, its impact in patients implanted with a left ventricular assist device (LVAD) remains unclear. We aimed to investigate the prevalence of SDB in patients with LVAD and its impact on their clinical outcomes. Fifty consecutive patients with LVAD who underwent portable sleep monitoring between September 2017 and April 2018 were prospectively enrolled, and they were followed up for 170 ± 36 days. According to their respiratory disturbance indexes (RDIs), they were categorized into the SDB group (RDI ≥ 15, n = 12) and the non-SDB group (RDI < 15, n = 38). The incidence of adverse events during the follow-up period was investigated after enrollment. Multivariate logistic regression analysis revealed significant differences in SDB in LVAD-implanted patients in terms of the logarithmic transformation brain natriuretic peptide (BNP) values (p = 0.005). The optimal BNP cut-off value for SDB prediction in LVAD-implanted patients was 300 pg/mL (sensitivity: 58.3%, specificity: 94.7%). During follow-up, ventricular tachyarrhythmias (VTas) occurred significantly more frequently in the SDB group (4 [33%] vs. 2 [5%] patients, p = 0.02); Atrial tachyarrhythmia (ATa) also tended to occur more frequently in the SDB group (2 [25%] vs. 2 [2%] patients, p = 0.07). SBD was prevalent in 24% of the LVAD-implanted patients with advanced HF. Furthermore, SDB was significantly associated with high BNP levels and was also potentially associated with subsequent incidence of VTa in patients with LVAD.

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Authors and Affiliations

  1. Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan

    Yuto Kumai, Osamu Seguchi, Hiroki Mochizuki, Yuki Kimura, Keiichiro Iwasaki, Kensuke Kuroda, Seiko Nakajima, Takuya Watanabe, Masanobu Yanase & Norihide Fukushima

  2. Department of Pulmonology and Infection Control, National Cerebral and Cardiovascular Center, Osaka, Japan

    Yorihiko Matsumoto & Makoto Sata

  3. Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan

    Satsuki Fukushima, Tomoyuki Fujita & Junjiro Kobayashi

  4. Department of Cardiology, Tokyo Medical University, Tokyo, Japan

    Taishiro Chikamori

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  1. Yuto Kumai
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Kumai, Y., Seguchi, O., Mochizuki, H. et al. Impact of sleep-disordered breathing on ventricular tachyarrhythmias after left ventricular assist device implantation. J Artif Organs 25, 223–230 (2022). https://doi.org/10.1007/s10047-021-01307-y

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  • DOI: https://doi.org/10.1007/s10047-021-01307-y

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