Transvenous phrenic nerve stimulation improves symptoms associated with central sleep apnoea in heart failure patients

Introduction: Patients with central sleep apnoea (CSA) and heart failure (HF) often have overlapping symptoms. Clinical treatment of CSA primarily focuses on management of symptoms, such as frequent nighttime awakenings or arousals, daytime sleepiness and quality of life. Purpose: Transvenous phrenic nerve stimulation (TPNS) has demonstrated improvements in patient reported outcomes (PROs). This post-hoc analysis aims to identify which complaints patients with HF had and determine what types of improvements the most symptomatic patients experienced. Methods: Subjects with HF and moderate to severe CSA from the remedē System Pivotal Trial who had baseline and 12 month data were analyzed (N=75). Questions from PROs and general symptoms were analyzed to assess impact of TPNS therapy at 12 months. Results: On the baseline Epworth Sleepiness Scale (ESS), ≥50% of subjects with HF responded moderate or high (2-3) chance of dozing while sitting and reading (55%), watching television (56%) and lying down to rest in the afternoon (68%). Of those with baseline ≥moderate, 71%, 52% and 35%, respectively, improved to