# Transveneuze frenische zenuwstimulatie bij centraal slaapapneu en hartfalen

*geplaatst 2025-02-01 · Hartfalen · ESC heart failure · doi 10.1002/ehf2.15074 · https://hartvaat.nl/2025/02/01/transveneuze-frenische-zenuwstimulatie-bij-centraal-slaapapneu-en-hartfalen/*

Win ratio analyse van transveneuze frenische zenuwstimulatie bij centraal slaapapneu en hartfalen. De interventie verbeterde de ademhaling en slaapkwaliteit, wat een potentieel alternatief biedt voor CPAP/ASV.

## English: Win ratio analysis of transvenous phrenic nerve stimulation to treat central sleep apnoea in heart failure.

This win ratio analysis of phrenic nerve stimulation for central sleep apnea in heart failure showed improved apnea severity and clinical outcomes, supporting neuromodulation as a treatment for this common HF comorbidity.

## Abstract (original, from the publication)

AIMS: Central sleep apnoea (CSA) is present in 20-40% of heart failure (HF) patients and is associated with poor clinical outcomes and health status. Transvenous phrenic nerve stimulation (TPNS) is an available treatment for CSA in HF patients. The impact on HF outcomes is incompletely understood. The win ratio (WR) allows inclusion of multiple endpoint components, considers the relative severity of each component, and permits assessment of recurrent events in evaluation of clinical benefit. METHODS AND RESULTS: A WR hierarchy was pre-defined for analysis of the HF subgroup of the remedē® System Pivotal Trial. The analysis used three hierarchical components to compare all treated to all control subjects: longest survival, lowest HF hospitalization rate, and ≥2-category difference in Patient Global Assessment at 6 months. Sensitivity analyses were performed substituting Epworth Sleepiness Scale and 4% oxygen desaturation index for the third component, and a 4-component WR hierarchy was also evaluated. Ninety-one HF subjects, 43 receiving TPNS and 48 in the control group, provided 2064 pairwise comparisons. More patients treated with TPNS experienced clinical benefit compared with control (WR 4.92, 95% confidence interval 2.27-10.63, P < 0.0001). There were 1111 (53.83%) winning pairwise comparisons for the treatment group and 226 (10.95%) for the control group. Similarly, large WRs were observed for all additional WR hierarchies. CONCLUSIONS: This WR analysis of the remedē® System Pivotal Trial suggests that TPNS may be superior to untreated CSA in HF patients with CSA using a hierarchical clinical benefit endpoint composed of mortality, HF hospitalization, and health status.

Auteurs: William T Abraham, Olaf Oldenburg, Mitja Lainscak, Rami Khayat, Jerryll Asin, Piotr Ponikowski, Robin Germany, Scott McKane, Maria Rosa Costanzo

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Bron: ESC heart failure, https://doi.org/10.1002/ehf2.15074. Bijgewerkt 2026-07-03T18:39:14Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.