ASV and Heart Failure

[Walla Walla]

I know this is a old report but there has been a lot of talk about it in some threads. I thought I'd post a link for those who haven't read it before.

http://www.nejm.org/doi/full/10.1056/NEJ...Background

[SarcasticDave94]

Thanks.

[zzzZorro]

I know this is a old report but there has been a lot of talk about it in some threads. I thought I'd post a link for those who haven't read it before.

http://www.nejm.org/doi/full/10.1056/NEJ...Background

Walla- And then there is this.  Is one to believe a incomplete/possibly faulty test study embraced by the industry or a counter-claim by a couple MD's??

ASV in CHF Recommendations Too Restrictive

Be nice to know for sure, as a study can be conducted in a manner to skew data for the purpose of proving a desired point, OR in a manner to assess all data to be weighed and provide an accurate conclusion. Sort of a PC way to say, 'follow the money' maybe..

[SarcasticDave94]

One would think that swaying medical advice and professional medical opinions should not be tainted by money or risk violations of HIPPA...But that's what I get for thinking.

[Walla Walla]

zzzZorro,

I don't support the study. I just posted the link so others could read it. It's up to everyone to draw their own conclusions.
I myself found it to have too many missing facts.

1. Of those that died what was their actual LVEF? We know all were at or below 45. But maybe those that died were well below that.

2. What were the ages of those that died?

3. What were the hours of compliance of those who died?

4. What was the average API of those who died?

What if it turns out the average person who died was 80 who only used his ASV 3 hours a night and had a LVEF of 30%.

The whole 45% LVEF thing was a knee jerk reaction to fear of lawsuits with no factual basis.

[Sleeprider]

zzz, thanks for posting that link. I have bookmarked it for future reference. I'll return the favor:

http://erj.ersjournals.com/content/42/Suppl_57/P324 don't overlook the recommended links and studies at the bottom of that.

[SarcasticDave94]

All valid questions Walla Walla. Wonder what the answers are.

[zzzZorro]

 

The whole 45% LVEF thing was a knee jerk reaction to fear of lawsuits with no factual basis.

Exactly.  Off the top of my head this reeks of a "Study" directed to discredit ASV use.  Why?  Well, lets see:  The first thing that pops to mind, Medicare and the Insurance industry harvests untold millions by excluding those in the LVEF<45% "finding" (really now a mandate).  And, if/when the whole truth and facts finally find the "Study" to be incorrect, look at all the sorry Bas***ds they eliminated in the interim as a bonus [$$-savings to them].

[chacha897d]

Just curious, how do you know for sure the data is skewed? Or is there a counter-study to debunk it?

---

My concern is that even if all the questions are valid, there is no surefire way to prove the study is wrong. Is it worth taking the risk unless you have a study that debunks the claim

[SarcasticDave94]

1. I used ASV for 2 years with a heart condition that lowers my LVEF, measured on echocardiogram at 55% before ASV, after on ASV those 2 years LVEF 64%, I have PVCs a timing issue

2. I can't use ASV now because COPD/Asthma needs timing controls that cannot be set manually on the ResMed AirCurve 10 ASV

3. Yes the SERVE-HF was flawed, there's mention that the included test subjects had a rather advanced heart failure condition already, ASV did NOT make them have CHF

link to one medical opinion on SERVE-HF, as an example

ScienceDirect