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Article Dans Une Revue Respirology Case Reports Année : 2020

Interrelated atrial fibrillation and leaks triggering and maintaining central sleep apnoea and periodic breathing in a CPAP ‐treated patient

Arnaud Prigent
Anne‐laure Serandour
  • Fonction : Auteur
Régis Luraine
  • Fonction : Auteur
Jean Sébastien Poineuf
  • Fonction : Auteur
Christian Bosseau
  • Fonction : Auteur

Résumé

Abstract 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.

Dates et versions

hal-04510878 , version 1 (19-03-2024)

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Citer

Arnaud Prigent, Anne‐laure Serandour, Régis Luraine, Jean Sébastien Poineuf, Christian Bosseau, et al.. Interrelated atrial fibrillation and leaks triggering and maintaining central sleep apnoea and periodic breathing in a CPAP ‐treated patient. Respirology Case Reports, 2020, 8 (8), ⟨10.1002/rcr2.666⟩. ⟨hal-04510878⟩

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