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Schlafbezogene Atmungsstörungen und kardiale Resynchronisationstherapie

Sleep-disordered breathing and cardiac resynchronization therapy

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Zusammenfassung

Patienten mit fortgeschrittener Herzinsuffizienz leiden häufig an schlafbezogenen Atmungsstörungen (SBAS). Unter kardialer Resynchronisationstherapie (CRT) wird nicht nur die Herzleistung signifikant gebessert, sondern auch das zentrale Schlaf-Apnoe-Syndrom mit Cheyne-Stokes-Atmung. Die Auswirkungen der CRT auf das obstruktive Schlaf-Apnoe-Syndrom scheinen eher gering bis nicht vorhanden zu sein. Auch ist der zusätzliche Einsatz einer atrialen Überstimulation zur CRT von klinisch untergeordneter Bedeutung. Unter CRT bessern sich nicht nur die klinischen Parameter des Schlafs, sondern auch die Schlafqualität, das subjektive Wohlbefinden durch eine Abnahme depressiver Syndrome und die Langzeitüberlebensprognose. Daher sollten alle Patienten mit Herzinsuffizienz und Indikation zur CRT hinsichtlich SBAS untersucht und bei positivem Befund im Langzeitverlauf nach CRT-Aggregatimplantation nachbeobachtet werden.

Abstract

Patients with progressive heart failure often suffer from sleep-disordered breathing (SDB). Upon receiving cardiac resynchronization therapy (CRT), there is an improvement of cardiac function and central sleep apnea syndrome (CSA) with Cheyne–Stokes respiration; however, effects of CRT on obstructive sleep apnea syndrome seemed to be without clinical relevance. Likewise, additional atrial overdrive pacing did not improve CRT effects relevantly in CSA patients. During CRT, there is an improvement in sleep parameters, sleep quality by reduction of depressive syndromes, and in long-term survival. Therefore, all patients with chronic heart failure and indication for CRT should be monitored regarding SDB before and after CRT device implantation.

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  1. Klinik für Kardiologie, Pneumologie und Internistische Intensivmedizin, Sana Klinikum Hof, Eppenreuther Str. 9, 95032, Hof, Deutschland

    A.-M. Sinha

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Sinha, AM. Schlafbezogene Atmungsstörungen und kardiale Resynchronisationstherapie. Herzschr. Elektrophys. 23, 5–8 (2012). https://doi.org/10.1007/s00399-012-0168-z

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