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This study determined the prevalence and predictors of a high nocturnal ventricular arrhythmia burden in patients with HFrEF and CSA (with and without CSR) and to evaluate the temporal association between CSR and the ventricular arrhythmia burden.<\/jats:p><jats:p>\u2003This cross-sectional ancillary analysis included 239 participants from the SERVE-HF major sub-study who had HFrEF and CSA, and nocturnal ECG from polysomnography. CSR was stratified in \u226520% and &lt;20% of total recording time (TRT). High burden of ventricular arrhythmia was defined as &gt;30 premature ventricular complexes (PVCs) per hour of TRT. A sub-analysis was performed to evaluate the temporal association between CSR and ventricular arrhythmias in sleep stage N2.<\/jats:p><jats:p>\u2003High ventricular arrhythmia burden was observed in 44% of patients. In multivariate logistic regression analysis, male sex, lower systolic blood pressure, non-use of antiarrhythmic medication and CSR \u226520% were significantly associated with PVCs &gt;30\u00b7h<jats:sup>\u22121<\/jats:sup>(OR 5.49, 95% CI 1.51\u201319.91, p=0.010; OR 0.98, 95% CI 0.97\u20131.00, p=0.017; OR 5.02, 95% CI 1.51\u201319.91, p=0.001; and OR 2.22, 95% CI 1.22\u20134.05, p=0.009; respectively). PVCs occurred more frequently during sleep phases with<jats:italic>versus<\/jats:italic>without CSR (median (interquartile range): 64.6 (24.8\u2013145.7)<jats:italic>versus<\/jats:italic>34.6 (4.8\u201375.2)\u00b7h<jats:sup>\u22121<\/jats:sup>N2 sleep; p=0.006).<\/jats:p><jats:p>\u2003Further mechanistic studies and arrhythmia analysis of major randomised trials evaluating the effect of treating CSR on ventricular arrhythmia burden and arrhythmia-related outcomes are warranted to understand how these data match with the results of the parent SERVE-HF study.<\/jats:p>","DOI":"10.1183\/23120541.00147-2021","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T09:35:13Z","timestamp":1621935313000},"page":"00147-2021","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Ventricular arrhythmia in heart failure patients with reduced ejection fraction and central sleep 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