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

Yuto Kumai, Osamu Seguchi, Hiroki Mochizuki, Yuki Kimura, Keiichiro Iwasaki, Kensuke Kuroda, Seiko Nakajima, Yorihiko Matsumoto, Takuya Watanabe, Masanobu Yanase, Makoto Sata, Satsuki Fukushima, Tomoyuki Fujita, Taishiro Chikamori, Junjiro Kobayashi, Norihide Fukushima

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
JournalJournal of Artificial Organs
DOIs
Publication statusAccepted/In press - 2022
Externally publishedYes

Keywords

  • Advanced heart failure
  • Left ventricular assist device
  • Sleep-disorder breathing
  • Ventricular tachyarrhythmia

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Impact of sleep-disordered breathing on ventricular tachyarrhythmias after left ventricular assist device implantation'. Together they form a unique fingerprint.

Cite this