Arrhythmias in Patients with Cardiac Implantable Electrical Devices after Implantation of a Left Ventricular Assist Device

Rosenbaum, Andrew; Kremers, Walter K.; Duval, Sue; Sakaguchi, Scott; Eckman, Peter

doi:10.1097/mat.0000000000000349

Cited by 11 publications

(2 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data for LVAD patient monitoring can be acquired from a variety of sources (Figure 1), including external devices such as point-of-care international normalized ratio (INR) monitors (15,16), or from implantable devices such as cardioverter-defibrillators (ICD)/pacemakers (17), left atrial pressure sensors (18) and pulmonary artery pressure sensors (19). There have also been developments to include sensors directly into the LVAD system.…”

Section: Introductionmentioning

confidence: 99%

The left ventricular assist device as a patient monitoring system

Moscato¹,

Gross²,

Schlöglhofer³

et al. 2021

Ann Cardiothorac Surg

View full text Add to dashboard Cite

Technological progress of left ventricular assist devices (LVADs) towards rotary blood pumps and the optimization of medical management contributed to the significant improvements in patient survival as well as LVAD support duration. Even though LVAD therapy is now well-established for end-stage heart failure patients, the long-term occurrence of adverse events (AE) such as bleeding, infection or stroke, still represent a relevant burden. An early detection of AE, before onset of major symptoms, can lead to further optimization of patient treatment and thus mitigate the burden of AE. Continuous patient monitoring facilitates identification of pathophysiological states and allows anticipation of AE to improve patient management. In this paper, methods, algorithms and possibilities for continuous patient monitoring based on LVAD data are reviewed. While experience with continuous LVAD monitoring is currently limited to a few centers worldwide, the pace of developments in this field is fast and we expect these technologies to have a global impact on the well-being of LVAD patients.

show abstract

Section: Introductionmentioning

confidence: 99%

The left ventricular assist device as a patient monitoring system

Moscato¹,

Gross²,

Schlöglhofer³

et al. 2021

Ann Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…Although CPC is expected to increase cardiovascular circulation and reduce cardiac load, it has not been implemented clinically because of the possible adverse effects on the heart in the event of CPC failure [ 7 – 9 ]. Patients with VADs are at a higher risk of developing arrhythmia, which can induce CPC failure [ 10 , 11 ]. Therefore, prior to engaging in CPC, it should be confirmed that failure of the VAD will not cause the patient’s hemodynamic state or cardiac load to worsen.…”

Section: Introductionmentioning

confidence: 99%

Windkessel model of hemodynamic state supported by a pulsatile ventricular assist device in premature ventricle contraction

et al. 2018

View full text Add to dashboard Cite

BackgroundCounter-pulsation control (CPC) by ventricular assist devices (VADs) is believed to reduce cardiac load and increase coronary perfusion. However, patients with VADs have a higher risk of arrhythmia, which may cause the CPC to fail. Consequently, CPC has not been applied by VADs in clinical practice. The phase-locked loop (PLL) algorithm for CPC is readily implemented in VADs; however, it requires a normal, consistent heartbeat for adequate performance. When an arrhythmia occurs, the algorithm maintains a constant pumping rate despite the unstable heartbeat. Therefore, to apply the PLL algorithm to CPC, the hemodynamic effects of abnormal heartbeats must be analyzed.ObjectivesThis study sought to predict the hemodynamic effects in patients undergoing CPC using VADs, based on electrocardiogram (ECG) data, including a wide range of heart rate (HR) changes caused by premature ventricular contraction (PVC) or other reasons.MethodsA four-element Windkessel hemodynamic model was used to reproduce the patient’s aortic blood pressure in this study. ECG data from 15 patients with severe congestive heart failure were used to assess the effect of the CPC on the patients’ hemodynamic state. The input and output flow characteristics of the pulsatile VAD (LibraHeart I, Cervika, Korea) were measured using an ultrasound blood flow meter (TS410, Transonic, USA), with the aortic pressure maintained at 80–120 mmHg. All other patient conditions were also reproduced.ResultsIn patients with PVCs or normal heartbeats, CPC controlled by a VAD reduced the cardiac load by 20 and 40%, respectively. When the HR was greater for other reasons, such as sinus tachycardia, simultaneous ejection from the heart and VAD was observed; however, the cardiac load was not increased by rapid cardiac contractions resulting from decreased left ventricle volume. These data suggest that the PLL algorithm reduces the cardiac load and maintains consistent hemodynamic changes.

show abstract