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+--- Thread: ASV and LVEF<45% (/Thread-ASV-and-LVEF-45)
ASV and LVEF<45% - zzzZorro - 10-17-2017
This is a break-off of the previous thread as it has spun off the original question and into the ASV realm.
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Waiting for the results of the Sleep Lab to get to the Sleep Doc and for him to act on it. In the meantime at the Lab Tech’s suggestion the APAP I was using has been shelved since September 27th. Even though the APAP was non-prescription it noticeably helped the rest factor and nocturnal polyuria [nocturia]. Anyone suffering from this malaise understands, especially when coupled with awakenings about 3am for a two hour sleep deprivation, it becomes a debilitating episode. The APAP is about to be put back into action soon if the Doc doesn’t get with it soon.
Last night I ran the CMS-50D+ to check on the SP02. There is no APAP available with it. The 1.5 hour mark is where I think I fell asleep and is indicative I think with what the Tech stated, “There is a bunch of CA’s in the transition period into sleep”. Interesting that she also told me the BIPAP did not get a handle on it and the LVEF<45 excludes me for ASV. [Ominous prediction?]
Appreciate it if anyone understanding the Oxiometer chart would elaborate on it. There are probably six, or so, 'P' breaks if anything looks odd.. I took it off when I awoke about 3:00am..
After I get the second SleepStudy report I am thinking about posting both here. Trying to contact the Cardiologist today to see if he can intervene if/when the SleepDoc zips the ASV?!?
RE: ASV and LVEF<45% - Spy Car - 10-17-2017
zzzZoro, I wish you good fortune moving through this process.
It was curious to me that when my sleep doctor got my ASV sleep labs back, he said it looks like ASV is the thing.
I asked, "now do I need to do an EKG?"
He said "no, you don't show signs of this that or the other thing, so no?"
Then he added, "unless you want to do an EKG?"
I backtracked as fast as possible saying "no, no, no...I'm good to go."
I hope you find the right answer.
Bill
RE: ASV and LVEF<45% - zzzZorro - 10-17-2017
(10-17-2017, 02:32 PM)Spy Car Wrote: "no, no, no...I'm good to go."
Bill
Your Doc most probably knows what he is doing and you got what you needed, That's good!
A little education on the side might be good to know what got everyone's shorts in a bind with ASV. Given the choice I would sign a waver and use it myself if it stopped the CA's.
ResmedFAQ
RE: ASV and LVEF<45% - Sleeprider - 10-17-2017
In cases where LVEF is <45% and ASV is not prescribed, it's my observation that CPAP with fixed pressure and supplemental oxygen to maintain SSpO2 is a decent alternative. We have a new member here that is showing advance CSR and very high AHI that is maintaining over 95% SpO2 with 4 L/min oxygen (he doesn't know it yet). Just saying...get the ASV if you can, but if you can't see about an oxygen concentrator and bleeding oxygen into a CPAP circuit. We have seen events worse than yours treated and maintained with CPAP + oxygen. It takes a flexible and wide view of the treatment and objectives.
RE: ASV and LVEF<45% - Spy Car - 10-17-2017
(10-17-2017, 02:59 PM)zzzZorro Wrote:(10-17-2017, 02:32 PM)Spy Car Wrote: "no, no, no...I'm good to go."
Bill
Your Doc most probably knows what he is doing and you got what you needed, That's good!
A little education on the side might be good to know what got everyone's shorts in a bind with ASV. Given the choice I would sign a waver and use it myself if it stopped the CA's.
[ResMed Letterhead]
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[url=https://www.resmed.com/us/dam/documents/serve-hf/Healthcare_%20providers_%20SERVE-HF_%20FAQs.pdf]
The guy came out of the Stanford Sleep Clinic. I have to believe he know's what he's doing.
It was one of those moments when I wished I'd kept my yap shut.
Bill
ETA: I'd sign the same waiver myself, but can't advise anyone else what to do. To my mind, the risks of non-treatment are worse than those in the ResMed study.
RE: ASV and LVEF<45% - zzzZorro - 10-17-2017
(10-17-2017, 03:13 PM)Sleeprider Wrote: In cases where LVEF is <45% and ASV is not prescribed, it's my observation that CPAP with fixed pressure and supplemental oxygen to maintain SSpO2 is a decent alternative. We have a new member here that is showing advance CSR and very high AHI that is maintaining over 95% SpO2 with 4 L/min oxygen (he doesn't know it yet). Just saying...get the ASV if you can, but if you can't see about an oxygen concentrator and bleeding oxygen into a CPAP circuit. We have seen events worse than yours treated and maintained with CPAP + oxygen. It takes a flexible and wide view of the treatment and objectives.
Good to know, I'll keep it in the back of my mind when the call finally arrives. I will definitely suggest it.
After 3-weeks waiting with the S9 APAP parked on the shelf, tonight it is coming out anyway and it's going to run at straight 20cm/APR off, to see if I can get some rest!
RE: ASV and LVEF<45% - SarcasticDave94 - 10-17-2017
(10-17-2017, 03:21 PM)Spy Car Wrote: ETA: I'd sign the same waiver myself, but can't advise anyone else what to do. To my mind, the risks of non-treatment are worse than those in the ResMed study.
Yep. Me too if necessary.
RE: ASV and LVEF<45% - Sleeprider - 10-17-2017
(10-17-2017, 03:50 PM)zzzZorro Wrote:(10-17-2017, 03:13 PM)Sleeprider Wrote: In cases where LVEF is <45% and ASV is not prescribed, it's my observation that CPAP with fixed pressure and supplemental oxygen to maintain SSpO2 is a decent alternative. We have a new member here that is showing advance CSR and very high AHI that is maintaining over 95% SpO2 with 4 L/min oxygen (he doesn't know it yet). Just saying...get the ASV if you can, but if you can't see about an oxygen concentrator and bleeding oxygen into a CPAP circuit. We have seen events worse than yours treated and maintained with CPAP + oxygen. It takes a flexible and wide view of the treatment and objectives.
Good to know, I'll keep it in the back of my mind when the call finally arrives. I will definitely suggest it.
After 3-weeks waiting with the S9 APAP parked on the shelf, tonight it is coming out anyway and it's going to run at straight 20cm/APR off, to see if I can get some rest!
If you are seriously willing to accept the risk and costs, just contact one of the Amazon sellers and ask if they can quote the Aircurve 10 ASV. It will be the most financially efficient ways to get what you need, and we will be more than happy to get you setup. I am going to be the first to say I give the SERVE-HF study very little credibility.
RE: ASV and LVEF<45% - SarcasticDave94 - 10-17-2017
Just IMO but armed with proper reports via SleepyHead, even an ASV is relatively easy to determine setting requirements.
RE: ASV and LVEF<45% - zzzZorro - 10-17-2017
(10-17-2017, 04:14 PM)Sleeprider Wrote: If you are seriously willing to accept the risk and costs, just contact one of the Amazon sellers and ask if they can quote the Aircurve 10 ASV. It will be the most financially efficient ways to get what you need, and we will be more than happy to get you setup. I am going to be the first to say I give the SERVE-HF study very little credibility.
$2100.00 on Amazon. From what I can see that is about (+/-) the cost of an Oxygen Concentartor that you would not need then. Maybe they are not constrained by the SERVE-HF dictum
