[HEART PAP (adapted-servo ventilation; ASV) is effective for the ventilation of chronic heart failure patient with Cheyne-Stokes respiration].

METHODS

A 72-year-old man with chronic heart failure had received implantation with a pacemaker for type III sick sinus syndrome in 2002. Mixed type sleep apnea syndrome (SAS) was diagnosed in 2004, and continuous positive airway pressure (CPAP) treatment was started. However, CPAP use become gradually difficult over the following 2 years. Atrial flutter was detected in December, 2006 and his heart failure became exacerbated. Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) was additionally found by the examination of PSG at that time. It was thought that he could not adjust his breathing to CPAP ventilation, because of the heart failure exacerbation. We introduced the HEART PAP (Respironics Inc. Murrysville, PA, USA) which was an adaptive-servo ventilator (ASV) on March 9, 2007. Mask wearing improved, and Cheyne-Stokes respiration and night hypoxemia disappeared. He showed improvement in sleep parameters and did not show the heart failure exacerbation diminished. It was recognized that the ASV yielded not only improvement of the respiratory status of this patient with heart failure but also an improvement of the cardiac function. Therefore, we should consider ASV for CSR-CSA patient who does not respond well to CPAP.