Interrelated atrial fibrillation and leaks triggering and maintaining central sleep apnoea and periodic breathing in a CPAP‐treated patient
| Autor: | Anne-Laure Serandour, Arnaud Prigent, Regis Luraine, Christian Bosseau, Jean-Louis Pépin, Jean Sébastien Poineuf |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Cardiac function curve medicine.medical_specialty Leak central sleep apnoea periodic breathing medicine.medical_treatment CPAP leaks Case Report Case Reports Cardioversion 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Continuous positive airway pressure lcsh:RC705-779 Ejection fraction business.industry Atrial fibrillation lcsh:Diseases of the respiratory system trigger medicine.disease respiratory tract diseases 030228 respiratory system 030220 oncology & carcinogenesis Periodic breathing Breathing Cardiology cardiovascular system business |
| Zdroj: | Respirology Case Reports Respirology Case Reports, Vol 8, Iss 8, Pp n/a-n/a (2020) |
| ISSN: | 2051-3380 |
| Popis: | We report the case of a 71‐year‐old obese continuous positive airway pressure (CPAP)‐treated man who developed an acute cardiac failure (ACF) triggered by atrial fibrillation. CPAP data downloaded from the CPAP software (Rescan®) retrospectively demonstrated the progressive development of a high residual central apnoea–hypopnoea index (AHI) with Cheyne–Stokes respiration (CSR). The AHI decreased after cardioversion allowing normalization of cardiac rhythm and function. Raw data extracted from CPAP software showed a gradual decrease in the periodic breathing cycle length related to a simultaneous improvement in left ventricular ejection fraction (LVEF) after cardioversion. During this clinical period of respiratory instability in the presence of cardiac failure, CSR episodes were exacerbated by ventilation overshoots followed by micro‐arousals induced by leaks. This might explain the high night to night variability of CSR occurrence in susceptible patients with impaired cardiac function. Beyond attempts to improve cardiac function, leak reduction might represent an important target for CSR management. Prior to acute cardiac failure triggered by atrial fibrillation, data from the patient's continuous positive airway pressure (CPAP) device demonstrated the progressive development of high residual central apnoea–hypopnoea index with Cheyne–Stokes respiration (CSR) that both decreased after cardioversion with normalization of cardiac rhythm and function, decrease in periodic breathing cycle length, and improvement in left ventricular ejection fraction (LVEF). CSR episodes were exacerbated by ventilation overshoots following micro‐arousals induced by leaks. |
| Databáze: | OpenAIRE |
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