Role of obstructive sleep apnea on the response to cardiac resynchronization therapy and all-cause mortality

Background The role of obstructive sleep apnea (OSA) on the response to cardiac resynchronization therapy (CRT) and all-cause mortality in patients with advanced heart failure (HF) is unknown. Objective We assessed the association between OSA, response to CRT, and all-cause mortality in patients with HF. Methods We analyzed records of 548 consecutive patients (mean age 65 ± 13 years; 216 (39%) women; mean follow-up period 76 ± 17 months) who received a CRT-defibrillator device from January 15, 2007 to March 30, 2016 at our tertiary care referral center. Results A total of 180 patients (33%) had OSA. Fewer patients in the OSA group (109 [61%]) had improvement in left ventricular ejection fraction (EF) than did those in the non-OSA group (253 [69%]) ( P = .001). A total of 144 patients (27%) died by the end of follow-up (OSA group: 61 [33%]; non-OSA group 83 [23%]; P Conclusion OSA is associated with a decreased response to CRT and an increase in all-cause mortality in patients with HF. The differential effect of OSA on CRT response in patients with ischemic cardiomyopathy and nonischemic cardiomyopathy needs further study.