Specialists report that the SERVE-HF study, which revealed the dangers of adaptive servo-ventilation in sleep apnea patients with heart failure, is a significant clinical finding.
The SERVE-HF researchers reported in the New England Journal of Medicine in September that “in patients with central sleep apnea and heart failure with a low ejection fraction (<45%) who used adaptive servo-ventilation (ASV) compared with similar subjects who did not use ASV, the risk of cardiovascular death was increased by 34%.”
In an accompanying NEJM editorial, two experts recommended “that adaptive servo-ventilation not be used outside clinical trials in patients with heart failure who have predominantly central sleep apnea.”
The results appear to have genuinely changed clinical practice. “After these data were presented, sleep clinicians stopped using ASV in patients with heart failure, central sleep apnea, and a low ejection fraction. This was a significant change in how we manage such patients,” said Richard Schwab, MD, co-medical director of the Penn Sleep Center in Philadelphia.
“SERVE-HF was a well-designed and executed study and because of it we now know that ASV therapy should not be used to treat central sleep apnea in people with symptomatic chronic heart failure with reduced ejection fraction”, said Sanjeev V. Kothare, MD, a sleep specialist at NYU Langone Medical Center in New York City.