MEDICAL REVIEW OF LIT (SLEEP APNEA)
Transvenous Phrenic Nerve Stimulation for the Treatment of Central Sleep Apnoea in Heart Failure
A total number of people that were included in the study to estimate the feasibility of using unilateral Transvenous phrenic nerve stimulation for the treatment of CSA in heart failure patients were sixteen. Fifteen people were excluded from the study due to varied reasons. For example, some of these individuals were eliminated due to technically inadequate capture of the phrenic nerve during neurostimulation. The inclusion criteria were the ability to hold an apnoea-hypopnoea index that is greater than or equals to 15 and a central apnoea index that is greater than or equal to 15. Exclusion criteria were when a patient had a baseline oxygen saturation that is less than 90%. Some of the activities that were done in the study were phrenic nerve stimulation and recording of the electroencephalogram. The investigation resulted in some issues. For example, there was the elimination of CSA in one of the patients since the effects were adverse. Moreover, stimulation contributed to significant improvement of all evaluated indices thus showing the severity of CSA. Therefore, the study portrayed the viability of unilateral transvenous phrenic nerve stimulation for the treatment of CSA in heart failure.
Treatment of Sleep Apnea in Chronic Heart Failure Patients with Auto-Servo Ventilation Improves Sleep Fragmentation: A Randomized Controlled Trial
One hundred and ninety-four individuals were included in the study that aimed at establishing whether auto-servo ventilation can reduce sleep fragmentation and improve sleeping efficiency among patients with chronic heart failure. A total of 122 people were excluded from the study due to varied reasons. For example, some people declined to participate in the study while other individuals failed to meet the inclusion criteria. For instance, 117 individuals did not achieve inclusion requirements while five individuals refused to participate in the study. Inclusion criteria were that an individual should be between 18-80 years, one should be non-ischemic, proper heart association, stable clinical status and stable optimal medical therapy. Exclusion criteria include unstable angina, admissions to any hospital in recent months, myocardial infarction, and cardiac surgery, individuals under oxygen therapy, obstructive airways disease, and the existence of primary valve disease. Some of the activities in the study include follow up programs to groups that received diagnostic PSG and provision of allocation intervention. The research established that ASV treatment improves sleep fragmentation. Moreover, sleep efficiency in CHF patients also improves as a result of ASV.
Design Of The Remed!E System Pivotal Trial: A Prospective, Randomized Study In The Use Of Respiratory Rhythm Management To Treat Central Sleep Apnea
One hundred and seventy-three patients were included in the study to determine the feasibility of respiratory rhythm management to treat central sleep apnea. The study does do not display the exact number of patients that were excluded but rather show the possibility of a reduction in the number of patients due to varied reasons that are not related to the system. Exclusion criteria include evidence of phrenic nerve palsy, evidence of severe bipolar disorder, the presence of idiopathic pulmonary hypertension, limited pulmonary function, haemoglobin <8g/dL, and active infection among others. Inclusion criteria include eighteen years of age and above, medically stable for 30 days before baseline application, approved consent by relevant authorities such as the Medical Ethics Committee and high level of tolerance during the study. Some of the activities in the study include therapy initiation, conducting implantation procedures, and adjustment of adverse events related to implantation procedure, and administration of physical exams to patients to determine fitness among others. The result of the study was not displayed because the analysis was to be made later to assess the credibility of the research.
Transvenous Stimulation of Remede¯® Systemthe Phrenic Nerve For The Treatment Of Central Sleep Apnoea: 12 Months’ Experience With The Remede¯® System
The total number of individuals who were included in the study to estimate the effectiveness of Remede¯® System was 57. For example, seven patients were excluded from the study because of failure to place lead. Consequently, one patient experienced earlier lead dislodgement hence was unfit for the process. Moreover, another patient underwent LVAD placement thus dropping out of the study. Death is another aspect that led to the exclusion of individuals in the research. Inclusion criteria were that a patient must have AHI of not less than twenty events/h. Exclusion criteria lack stability, phrenic nerve palsy, history of cardiovascular accident, any form of coronary artery graft surgery, history of primary pulmonary hypertension and unstable angina among others. Some of the issues that were conducted in the study include implantation of the Remede¯® System, the connection of neurostimulator, assessment of the quality of life and therapy initiation. The investigation resulted in the realization that unilateral transvenous phrenic nerve stimulation can be corrected by Remede¯® System to improve key sleep parameters. Moreover, the study resulted in the death of three individuals that accumulates to 6.4%. Consequently, the study estimated that at during the process of Remede¯® System implantation, 49% of patients had some cardiac devices like implantable cardioverter-defibrillation.