Remote Monitoring of Left Ventricular Assist Device Parameters After HeartAssist‐5 Implantation

Abstract

Although several left ventricular assist devices (LVADs) have been used widely, remote monitoring of LVAD parameters has been available only recently. We present our remote monitoring experience with an axial-flow LVAD (HeartAssist-5, MicroMed Cardiovascular, Inc., Houston, TX, USA). Five consecutive patients who were implanted a HeartAssist-5 LVAD because of end-stage heart failure due to ischemic (n=4) or idiopathic (n=1) cardiomyopathy, and discharged from hospital between December 2011 and January 2013 were analyzed. The data (pump speed, pump flow, power consumption) obtained from clinical visits and remote monitoring were studied. During a median follow-up of 253 (range: 80-394) days, fine tuning of LVADs was performed at clinical visits. All patients are doing well and are in New York Heart Association Class-I/II. A total of 39 alarms were received from three patients. One patient was hospitalized for suspected thrombosis and was subjected to physical examinations as well as laboratory and echocardiographic evaluations; however, no evidence of thrombus washout or pump thrombus was found. The patient was treated conservatively. Remaining alarms were due to insufficient water intake and were resolved by increased water consumption at night and summer times, and fine tuning of pump speed. No alarms were received from the remaining two patients. We believe that remote monitoring is a useful technology for early detection and treatment of serious problems occurring out of hospital thereby improving patient care. Future developments may ease troubleshooting, provide more data from the patient and the pump, and eventually increase physician and patient satisfaction. Despite all potential clinical benefits, remote monitoring should be taken as a supplement to rather than a substitute for routine clinical visits for patient follow-up.

Clinical implications of hemodynamic assessment during left ventricular assist device therapy

“…In the USA, the only devices that are approved for commercial use are the HeartMate II, HeartMate 3 (Abbott) [12] and HVAD (Medtronic, Minneapolis, MN, USA). The HeartAssist5 (ReliantHeart Inc., Houston, TX, USA) [13] and Jarvik 2000 are currently under investigation [14]. HVAD, HeartMate 3, and HeartAssist5 may be available in Japan shortly.…”

Fine-tuning management of the Heart Assist 5 left ventricular assist device with two- and three-dimensional echocardiography

“…The implantable flow probe also helps to assess even minor dehydration problems, which can be solved without admission to hospital. We experienced low-flow alarms during the summer months and suggested our patients take in extra fluid during summer 15. Fine-tuning of the Heart Assist 5 LVAD with the implantable flow probe and portable console was convenient, and the LVAD speed change echo studies enabled easy optimisation of the device during in-hospital echocardiographic studies.…”

The future of mechanical circulatory support for advanced heart failure

“…The information retrieved from the probe has been incorporated into the management of patients, allowing interventions prior to patients developing clinical signs and symptoms of HF or early device malfunction. The remote monitoring system was found to be useful and user friendly by the providers [37].…”