{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T20:35:50Z","timestamp":1770150950091,"version":"3.49.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"remed\u0113 System Pivotal trial"},{"name":"ZOLL Respicardia, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>To determine the effect of transvenous phrenic nerve stimulation (TPNS) on nocturnal heart rate perturbations in patients with CSA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this ancillary study of the remed\u0113 System Pivotal Trial, we analyzed electrocardiograms from baseline and follow-up overnight polysomnograms (PSG) in 48 CSA patients in sinus rhythm with implanted TPNS randomized to stimulation (treatment group; TPNS on) or no stimulation (control group; TPNS off). We quantified heart rate variability in the time and frequency domain. Mean change from baseline and standard error is provided.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>TPNS titrated to reduce respiratory events is associated with reduced cyclical heart rate variations in the very low-frequency domain across REM (VLFI: 4.12 \u00b1 0.79% vs. 6.87 \u00b1 0.82%, p = 0.02) and NREM sleep (VLFI: 5.05 \u00b1 0.68% vs. 6.74 \u00b1 0.70%, p = 0.08) compared to the control group. Further, low-frequency oscillations were reduced in the treatment arm in REM (LFn: 0.67 \u00b1 0.03 n.u. vs. 0.77 \u00b1 0.03 n.u., p = 0.02) and NREM sleep (LFn: 0.70 \u00b1 0.02 n.u. vs. 0.76 \u00b1 0.02 n.u., p = 0.03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In adult patients with moderate to severe central sleep apnea, transvenous phrenic nerve stimulation reduces respiratory events and is associated with the normalization of nocturnal heart rate perturbations. Long-term follow-up studies could establish whether the reduction in heart rate perturbation by TPNS also translates into cardiovascular mortality reduction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trial<\/jats:title>\n                  <jats:p>A Randomized Trial Evaluating the Safety and Effectiveness of the remed\u0113\u00ae System in Patients With Central Sleep Apnea, ClinicalTrials.gov, NCT01816776<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsad166","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:22:31Z","timestamp":1686183751000},"source":"Crossref","is-referenced-by-count":5,"title":["Transvenous phrenic nerve stimulation is associated with normalization of nocturnal heart rate perturbations in patients with central sleep apnea"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2984-2167","authenticated-orcid":false,"given":"Mathias","family":"Baumert","sequence":"first","affiliation":[{"name":"Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide , Adelaide , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-0824","authenticated-orcid":false,"given":"Dominik","family":"Linz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute , Maastricht , The Netherlands"},{"name":"Centre for Heart Rhythm Disorders, The University of Adelaide and Royal Adelaide Hospital , Adelaide , Australia"},{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2886-6864","authenticated-orcid":false,"given":"Scott","family":"McKane","sequence":"additional","affiliation":[{"name":"ZOLL Respicardia, Inc. Minnetonka, MN , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Immanuel","sequence":"additional","affiliation":[{"name":"Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide , Adelaide , Australia"},{"name":"School of Business Information Systems, Torrens University , Adelaide , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"issue":"6","key":"2023090806282883400_CIT0001","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.jacc.2021.05.048","article-title":"Sleep disordered breathing and cardiovascular disease: JACC state-of-the-art review","volume":"78","author":"Cowie","year":"2021","journal-title":"J Am Coll 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