Effect of sleep-disordered breathing on appropriate implantable cardioverter-defibrillator therapy in patients with heart failure: A systematic review and meta-analysis

Younghoon Kwon, Ryan J. Koene, Osung Kwon, Jessica V. Kealhofer, Selcuk Adabag, Sue Duval

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background - Patients with heart failure and reduced ejection fraction are at increased risk of malignant ventricular arrhythmias. Implantable cardioverter-defibrillator (ICD) is recommended to prevent sudden cardiac death in some of these patients. Sleep-disordered breathing (SDB) is highly prevalent in this population and may impact arrhythmogenicity. We performed a systematic review and meta-analysis of prospective studies that assessed the impact of SDB on ICD therapy. Methods and Results - Relevant prospective studies were identified in the Ovid MEDLINE, EMBASE, and Google Scholar databases. Weighted risk ratios of the association between SDB and appropriate ICD therapies were estimated using random effects meta-analysis. Nine prospective cohort studies (n=1274) were included in this analysis. SDB was present in 52% of the participants. SDB was associated with a 55% higher risk of appropriate ICD therapies (45% versus 28%; risk ratio, 1.55; 95% confidence interval, 1.32-1.83). In a subgroup analysis based on the subtypes of SDB, the risk was higher in both central (risk ratio, 1.50; 95% confidence interval, 1.11-2.02) and obstructive (risk ratio, 1.43; 95% confidence interval, 1.01-2.03) sleep apnea. Conclusions - SDB is associated with an increased risk of appropriate ICD therapy in patients with heart failure and reduced ejection fraction.

Original languageEnglish (US)
Article numbere004609
JournalCirculation: Arrhythmia and Electrophysiology
Volume10
Issue number2
DOIs
StatePublished - Feb 1 2017

Keywords

  • death, sudden, cardiac
  • defibrillators, implantable
  • heart failure
  • meta-analysis
  • sleep apnea syndrome

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