Pressure Ramp Testing for Optimization of End-Expiratory Pressure Settings in Adaptive Servo-Ventilation Therapy

Adaptive Servo-Ventilation as a Novel Therapeutic Strategy for Chronic Heart Failure

The introduction of new therapeutics for patients with chronic heart failure, including sacubitril/valsartan, sodium-glucose cotransporter 2 inhibitors, and ivabradine, in addition to beta-blockers, angiotensin converting enzyme inhibitors, and mineralocorticoid receptor antagonists, lends an opportunity for significant clinical risk reduction compared to what was available just one decade ago. Further clinical options are needed, however, for patients with residual clinical congestion refractory to these therapies. Adaptive servo-ventilation is a novel therapeutic option to address significant clinical volume in cases resistant to medical therapy. The aggregate benefit of these additional therapeutic strategies in addition to foundational medical therapy may be a promising option in the selected candidates who do not achieve acceptable clinical and quality-of-life improvements with oral medical therapy alone. Now is the era to reconsider the implication of an adaptive servo-ventilation-therapy-incorporated medical therapeutic strategy for patients with congestive heart failure.