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Win ratio analysis of transvenous phrenic nerve stimulation to treat central sleep apnoea in heart failure.
ESC Heart Fail
October 2024
Midwest Cardiovascular Institute, Naperville, Illinois, USA.
Article Synopsis
- - The study investigates the effectiveness of transvenous phrenic nerve stimulation (TPNS) as a treatment for central sleep apnea (CSA) in heart failure (HF) patients, who often have poor health outcomes related to CSA.
- - Researchers used a win ratio (WR) method to analyze data from a pivotal trial, comparing outcomes such as survival rates, hospitalization for heart failure, and patient-reported health status between those treated with TPNS and a control group.
- - Results indicate that TPNS significantly improves clinical outcomes for HF patients with CSA, showing a higher number of positive outcomes for those receiving treatment compared to the control group.
Transvenous phrenic nerve stimulation reduces diaphragm injury during controlled mechanical ventilation in a preclinical model of ARDS.
J Appl Physiol (1985)
November 2024
Simon Fraser University, Burnaby, British Columbia, Canada.
Article Synopsis
- Patients with acute respiratory distress syndrome (ARDS) often suffer diaphragm dysfunction due to deep sedation and mechanical ventilation.
- The study investigated the effects of temporary transvenous diaphragm neurostimulation (TTDN) combined with mechanical ventilation on diaphragm injury and cytokine levels in pigs with induced ARDS.
- Results showed that TTDN significantly reduced abnormal diaphragm tissue and altered cytokine patterns compared to mechanical ventilation alone, suggesting its potential as a protective strategy in ARDS management.
An Initial Investigation of Diaphragm Neurostimulation in Patients with Acute Respiratory Distress Syndrome.
Anesthesiology
March 2024
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France; Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département "R3S"), Paris, France.
Background: Lung protective ventilation aims at limiting lung stress and strain. By reducing the amount of pressure transmitted by the ventilator into the lungs, diaphragm neurostimulation offers a promising approach to minimize ventilator-induced lung injury. This study investigates the physiologic effects of diaphragm neurostimulation in acute respiratory distress syndrome (ARDS) patients.
View Article and Find Full Text PDFTransvenous phrenic nerve stimulation for treating central sleep apnea may regulate sleep microstructure.
Sleep Med
January 2024
Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia. Electronic address:
Study Objectives: To assess the impact of transvenous phrenic nerve stimulation (TPNS) on non-rapid eye movement sleep microstructure quantified by cyclic alternating pattern (CAP) in individuals with central sleep apnea (CSA).
Methods: We analyzed baseline and 6-month follow-up overnight polysomnograms (PSG) in 134 CSA patients enrolled in the remedē System Pivotal Trial implanted with TPNS randomized (1:1) to neurostimulation (treatment group) or no stimulation (control group). Differences in CAP rate, A1 index, and A2+A3 index between study arms at follow-up were assessed using Analysis of Covariance adjusted for baseline values.
Transvenous phrenic nerve stimulation: setting up a clinical program.
Sleep Breath
May 2024
Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, 2012 Kenny Road, Columbus, OH, 43221, USA.
Background: Central sleep apnea (CSA) is a form of sleep-disordered breathing caused by a lack of the drive to breathe during sleep. Phrenic nerve stimulation (PNS) was approved in 2017 for treatment of moderate to severe CSA. However, information on setting up a successful PNS program is lacking.
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