Why the study?
Synchronization between the left ventricle and a left ventricular assist device may be important for ventricular unloading and coronary perfusion but has not been fully characterized.
Does synchronizing LVAD systole with specific delays relative to the cardiac cycle optimize ventricular unloading and flow in a healthy minipig model?
Does synchronizing LVAD systole with specific delays relative to the cardiac cycle optimize ventricular unloading and flow in a healthy minipig model?
Synchronizing LVAD contraction to the second half of the cardiac cycle (40-80% delay) optimizes ventricular unloading and increases total flow in a porcine model.
Synchronous LVAD timing may aid unloading in pulsatile devices; leaves open clinical translation and recovery benefit.
BACKGROUND: Synchronization between the left ventricle and a left ventricular assist device (LVAD) may be important for ventricular unloading and coronary perfusion. We assessed the synchrony between cardiac and LVAD cycles by increasing delays in steps of 100 msec throughout the cycle, under conditions of total and partial left ventricular support. METHODS: We studied 7 healthy minipigs weighing 30-40 kg. A 60-cc Berlin Heart Excor LVAD was implanted and connected to a BCM 1200 console, making it possible to synchronize the LVAD systole and the EKG signal with a prefixed delay. We recorded hemodynamic parameters (including aortic, pulmonary, and left ventricular pressure) and LVAD flow for each delay. RESULTS: Intraventricular pressure during LVAD systole was minimized with delays of around 40-80% of one cycle. In addition, total flow was higher under these conditions. CONCLUSIONS: This study shows that the synchronous mode of LVAD operation is feasible. Moreover, a delay in device contraction until the second half of the cardiac cycle optimizes ventricular unloading and may eventually improve myocardial recovery.
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Heredero et al. (2012) studied Healthy minipigs (n=7). Synchronization between cardiac and LVAD cycles with increasing delays was evaluated on Hemodynamic parameters (intraventricular pressure) and LVAD flow.
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