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Europace Advance Access originally published online on August 4, 2008
Europace 2008 10(9):1029-1033; doi:10.1093/europace/eun190
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

REVIEWS

Sleep-disordered breathing in heart failure and the effect of cardiac resynchronization therapy

Emmanuel N. Simantirakis1, Sophia E. Schiza2, Nikolas S. Siafakas2 and Panos E. Vardas1,*

1 Cardiology Department, Heraklion University Hospital, PO Box 1352, Heraklion, Crete, Greece; 2 Sleep Disorders Unit, Department of Thoracic Medicine, Faculty of Medicine, University of Crete, Crete, Greece

Respiratory disturbances during sleep are common in patients with heart failure (HF) and can trigger the occurrence of sleep apnoea or deteriorate pre-existing breathing disorder. This in turn may lead to worsening of the HF itself. Optimal treatment for HF has been found to reduce respiratory disturbances during sleep significantly, whereas cardiac resynchronization therapy (CRT), achieved by biventricular pacing, appears to cause a further reduction in episodes of central type apnoea, although it may also have an effect on episodes of obstructive type. The beneficial effect of CRT is due to the patients’ haemodynamic improvement and in the HF amelioration, and not due to some other effect resulting from the electrical stimulation of the heart. However, this therapeutic intervention by itself is insufficient for the effective treatment of respiratory disturbances during sleep and should be considered as an adjunctive treatment in addition to other established therapies.

Key Words: Cardiac resynchronization, Sleep apnoea, Heart failure

* Corresponding author. Tel: +30 2810 392422; fax: +30 2810 542055. E-mail address: cardio{at}med.uoc.gr or mximeris{at}excite.com

Manuscript submitted 22 April 2008. Accepted after revision 1 July 2008.


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