RT Journal Article SR Electronic T1 Ventricular arrhythmia in heart failure patients with reduced ejection fraction and central sleep apnoea JF ERJ Open Research JO erjor FD European Respiratory Society SP 00147-2021 DO 10.1183/23120541.00147-2021 A1 Christoph Fisser A1 Jannis Bureck A1 Lara Gall A1 Victoria Vaas A1 Jörg Priefert A1 Sabine Fredersdorf A1 Florian Zeman A1 Dominik Linz A1 Holger Woehrle A1 Renaud Tamisier A1 Helmut Teschler A1 Martin R. Cowie A1 Michael Arzt YR 2021 UL http://openres.ersjournals.com/content/early/2021/05/21/23120541.00147-2021.abstract AB Cheyne-Stokes respiration (CSR) may trigger ventricular arrhythmia in patients with heart failure with reduced ejection fraction (HFrEF) and central sleep apnoea (CSA). This study determined the prevalence and predictors of a high nocturnal ventricular arrhythmia burden in patients with HFrEF and CSA (with and without CSR) and to evaluate the temporal association between CSR and the ventricular arrhythmia burden.This cross-sectional ancillary analysis included 239 participants from the SERVE-HF major sub-study who had HFrEF and CSA, and nocturnal ECG from polysomnography. CSR was stratified in ≥20% and <20% of total recording time (TRT). High burden of ventricular arrhythmia was defined as >30 premature ventricular complexes (PVCs) per hour of TRT. A sub-analysis was performed to evaluate the temporal association between CSR and ventricular arrhythmias in sleep stage N2.High ventricular arrhythmia burden was observed in 44% of patients. In multivariate logistic regression analysis, male sex, lower systolic blood pressure, non-use of antiarrhythmic medication and CSR ≥20% were significantly associated with PVC >30/h (odds ratio [95% confidence interval]: 5.49 [1.51–19.91], p=0.010; 0.98 [0.97–1.00], p=0.017; 5.02 [1.51–19.91], p=0.001; and 2.22 [1.22–4.05]; p=0.009; respectively). PVCs occurred more frequently during sleep phases with versus without CSR (median [interquartile range]: 64.6 [24.8–145.7] versus 34.6 [4.8–75.2]/h N2 sleep; p=0.006).Further mechanistic studies and arrhythmia analysis of major randomised trials evaluating the effect treating CSR on ventricular arrhythmia burden and arrhythmia-related outcomes are warranted to understand how these data match with the results of the parent SERVE-HF study.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Fisser reports grants from German Heart Foundation/German Foundation of Heart Research, during the conduct of the study.Conflict of interest: Dr. Bureck has nothing to disclose.Conflict of interest: Dr. Gall has nothing to disclose.Conflict of interest: Dr. Vaas reports grants from German Society of Sleep Medicine, outside the submitted work.Conflict of interest: Dr. Priefert has nothing to disclose.Conflict of interest: Dr. Fredersdorf has nothing to disclose.Conflict of interest: Dr. Zeman has nothing to disclose.Conflict of interest: Dr. Linz reports personal fees from Bayer, personal fees from LivaNova, personal fees from ResMed, personal fees from Respicardia, outside the submitted work.Conflict of interest: Dr. Wöhrle reports other from ResMed, outside the submitted work.Conflict of interest: Dr. Tamisier reports grants from ResMed, personal fees from Agiradom, outside the submitted work.Conflict of interest: Dr. Teschler reports grants and personal fees from ResMed, outside the submitted work.Conflict of interest: Dr. Cowie reports grants and personal fees from ResMed, personal fees from Respicardia, grants from Bayer, outside the submitted work.Conflict of interest: Dr. Arzt reports grants from ResMed, during the conduct of the study; personal fees from ResMed, grants and personal fees from Philips Respironics, personal fees from Boehringer-Ingelheim, personal fees from NRI, personal fees from Novartis, personal fees from JAZZ pharmaceuticals, personal fees from Inspire, personal fees from Bresotec, grants from Else-Kroehner Fresenius Foundation, outside the submitted work.