Transvenous Phrenic Nerve Stimulation Impact On Patients With Heart Failure And Central Sleep Apnea

SESSION TITLE: Sleep Disorders Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Epworth Sleepiness Scale (ESS) is used to screen for subjective excessive daytime time sleepiness (EDS) in obstructive sleep apnea (OSA) but has not been validated to define EDS in patients with heart failure (HF) and central sleep apnea (CSA). Our and other laboratories have shown most patients with HF do not report EDS, yet when tested in laboratory by multiple sleep latency test, many exhibit short sleep latency. We hypothesized an ESS of 10-11, the threshold to define EDS in OSA in the general population, is not appropriate for patients with CSA and HF. In the pivotal randomized controlled trial (RCT) of transvenous phrenic nerve stimulation (TPNS), there were 96 patients with CSA and HF with a wide range (0-21) in ESS, with median=8. In this analysis, we investigated the impact of TPNS on outcomes based on ESS ≥8. METHODS: Outcomes were evaluated for subgroups having baseline ESS≥8 vs. ESS<8 within the Treatment (n=30 and 18, respectively) and Control (implanted but therapy inactive for 6 months, n=24 and 24, respectively) groups. Changes in ESS, sleep metrics and quality of life (QoL) were assessed at 6 months. P-values from exploratory analyses comparing results between TPNS ESS subgroups are reported. RESULTS: TPNS treated patients with ESS≥8 had significantly greater ESS improvement (n=30, median 12 at baseline vs 6.5 at 6 months) than the ESS<8 TPNS subgroup (n =18, 5 vs 5) [p$100000 Added 04/13/2020 by Robin Germany, source=Web Response, value=Salary no disclosure on file for Lee Goldberg; Consultant relationship with Respicardia Please note: $20001 - $100000 Added 04/09/2020 by Shahrokh Javaheri, source=Web Response, value=Honoraria Employee relationship with Respicardia Please note: >$100000 Added 04/12/2020 by Scott McKane, source=Web Response, value=Salary Employee relationship with Respicardia Please note: >$100000 Added 04/13/2020 by Timothy Meyer, source=Web Response, value=Salary