Heart, Lung and Circulation
Image| Volume 22, ISSUE 4, P300-302, April 2013

Immediate Amelioration of Mechanical Pulsus Alternans by Adaptive Servo-ventilation Therapy

Published:October 12, 2012DOI:
      Mechanical pulsus alternans is sometimes seen in patients with severe heart failure. This case report describes a patient with medically refractory acute heart failure due to severe left ventricular (LV) systolic dysfunction with pulsus alternans, where short-term adaptive servo-ventilation (ASV) therapy immediately ameliorated the mechanical pulsus alternans.
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        • Dickstein K.
        • Cohen-Solal A.
        • Filippatos G.
        • McMurray J.J.
        • Ponikowski P.
        • Poole-Wilson P.A.
        • et al.
        ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM).
        Eur Heart J. 2008; 29: 2388-2442
        • Philippe C.
        • Stoica-Herman M.
        • Drouot X.
        • Raffestin B.
        • Escourrou P.
        • Hittinger L.
        • et al.
        Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne–Stokes respiration in heart failure over a six month period.
        Heart. 2006; 92: 337-342
        • Haruki N.
        • Takeuchi M.
        • Kaku K.
        • Yoshitani H.
        • Kuwaki H.
        • Tamura M.
        • et al.
        Comparison of acute and chronic impact of adaptive servo-ventilation on left chamber geometry and function in patients with chronic heart failure.
        Eur J Heart Fail. 2011; 13: 1140-1146
        • Harada D.
        • Joho S.
        • Oda Y.
        • Hirai T.
        • Asanoi H.
        • Inoue H.
        Short term effect of adaptive servo-ventilation on muscle sympathetic nerve activity in patients with heart failure.
        Auton Neurosci. 2011; 161: 95-102
        • McGaughey M.D.
        • Maughan W.L.
        • Sunagawa K.
        • Sagawa K.
        Alternating contractility in pulsus alternans studied in the isolated canine heart.
        Circulation. 1985; 71: 357-362
        • Lab M.J.
        • Lee J.A.
        Changes in intracellular calcium during mechanical alternans in isolated ferret ventricular muscle.
        Circ Res. 1990; 66: 585-595
        • Kobayashi S.
        • Susa T.
        • Tanaka T.
        • Murakami W.
        • Fukuta S.
        • Okuda S.
        • et al.
        Low-dose beta-blocker in combination with milrinone safely improves cardiac function and eliminates pulsus alternans in patients with acute decompensated heart failure.
        Circ J. 2012; 76: 1646-1653