The SERVE-HF safety notice in clinical practice - experiences of a tertiary sleep center.

Brill, Anne-Kathrin; Pichler Hefti, Jacqueline Renée; Geiser, Thomas; Ott, Sebastian Robert (2017). The SERVE-HF safety notice in clinical practice - experiences of a tertiary sleep center. Sleep medicine, 37, pp. 201-207. Elsevier 10.1016/j.sleep.2017.02.007

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BACKGROUND In May 2015, the results of the SERVE-HF trial - addressing adaptive servoventilation (ASV) in chronic congestive heart failure (CHF) patients with central sleep apnea (CSA) - prompted a field safety notice. It was recommended to identify CHF patients treated with ASV and to advise the discontinuation of the treatment. We aimed to analyze the identification process and effect of ASV discontinuation on affected patients. METHODS 126 patients treated with ASV on May 13th, 2015 at our institution were retrospectively analyzed. Treatment decisions, effect of ASV discontinuation and clinical course were followed for a year. Patients on ASV with CHF were compared to those without CHF. RESULTS The risk criteria of the safety notice were fulfilled by 10.3% of patients (13/126). Additional echocardiographies were performed in 38%. ASV was discontinued in 93% of patients without adverse events (emergency hospitalization in n = 1). CSA reappeared immediately. Day- or nighttime symptoms were reported by 61%. Symptomatic patients were started on alternative treatments. CHF and non-CHF patients differed in cardiac function and type of SDB. CHF patients had shorter overall treatment duration. Compliance to ASV was similar in both groups with a median usage of 412 min (269; 495)/night in the CHF group and 414.5 min (347; 480) in the non-CHF group. CONCLUSION Identification of patients "at risk" is feasible but outcome of discontinuation of ASV cannot be evaluated based on these data. ASV withdrawal in patients with stable chronic CHF and CSA leads to an immediate return of sleep disordered breathing. Symptomatic patients may ask for alternative treatment options.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology

UniBE Contributor:

Brill, Anne-Kathrin; Pichler Hefti, Jacqueline Renée; Geiser, Thomas and Ott, Sebastian Robert

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1389-9457

Publisher:

Elsevier

Language:

English

Submitter:

Rahel Holderegger

Date Deposited:

27 Nov 2017 14:16

Last Modified:

27 Nov 2017 14:20

Publisher DOI:

10.1016/j.sleep.2017.02.007

PubMed ID:

28755899

Uncontrolled Keywords:

ASV discontinuation Adaptive servoventilation Central sleep apnea Heart failure SERVE-HF Sleep disordered breathing

BORIS DOI:

10.7892/boris.106595

URI:

https://boris.unibe.ch/id/eprint/106595

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