Withdrawing ASV therapy in clinical practice: trials and tribulations

On May 13, 2015, prior to publication of the results of the SERVE-HF Study,1 a field safety notice was issued identifying an increase in the risk of cardiovascular death (hazard ratio 1.34 [95% CI 1.09-1.65] P=0.006) in patients with symptomatic chronic heart failure (HF) with left ventricular ejection fraction (LVEF) ≤ 45% being treated with Adaptive Servo-ventilation (ASV). Three recommendations were made: physicians should identify and reassess all patients with symptomatic HF with reduced EF (HFrEF) currently being treated with ASV "with the aim of urgently stopping" such therapy.

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