Periodic breathing with no heart beat

A protocol was originally designed to study breathing control during and following cardiac arrest in humans, taking advantage of the period of pulseless ventricular fibrillation (PVF) produced while testing a newly implanted cardioverter-defibrillator device. A patient aged in his 60s with New York Heart Association class III heart failure (HF) (left ventricular ejection fraction of 25%) who was originally part of this study displayed permanent periodic breathing (PB) and was then excluded from the final data analysis; his response is presented in this report. The 8- to 9-s PVF was incidentally produced during the ascending phase of a PB cycle, followed by another 12-s recovery period of low BP. PVF and its recovery had no effect on PB characteristics (period or amplitude). This occurred despite a profound change in P ACO₂, cerebral blood flow, and perfusion of the carotid bodies. It is concluded that PB in patients with HF could be produced by primary oscillations originating from the central pattern generator.