0545 Comparison of Performance of Four Adaptive Servo Ventilation Devices In Patients With Complex Sleep Apnea

Abstract Introduction Adaptive Servo Ventilation (ASV) increased the risk for mortality in the SERVE-HF trial. The mechanisms for such a finding remain unclear. Conceivably, device algorithms that control respiratory rate and pressure support may have led to high minute ventilation, which, in turn, may have contributed to hypocapnia and life-threatening arrhythmias. Whether such a finding was due to a device algorithm-based effect (“device-effect”) or applies to all devices with servo-algorithm (“class-effect”) is uncertain. Our objective was to compare the performance of various ASV devices on indices of sleep-disordered breathing and minute ventilation. Methods We performed a randomized controlled cross-over trial of patients with complex sleep apnea with preserved cardiac contractility who were adherent with ASV therapy. Patients underwent four nights of laboratory-based polysomnography while receiving therapy from a Philips ASV device (System One), updated Philips ASV device (Dreamstation), ResMed S7 VPAP Adapt (used in the SERVE-HF trial), and ResMed S9 VPAP Adapt. Results During polysomnography, apnea-hypopnea index was not different across the different devices (P=0.9). Minute ventilation (VE) was greater during S7 device (9.8 ± 0.4 Lpm) when compared to all other devices for wakefulness state: S9 (4.9 ± 1.0 Lpm), Dream Station (8.4 ± 0.2 Lpm), and System One (8.6 ± 0.3 Lpm; P