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Effect of alteration in pump speed on pump output and left ventricular filling with continuous-flow left ventricular assist device. | LitMetric

AI Article Synopsis

  • - Third-generation continuous-flow left ventricular assist devices (LVADs) showed that varying pump speed affects flow rates and cardiac function in 13 stable outpatients, with a strong correlation between speed change and flow output.
  • - The average baseline pump speed was 2,073 RPM, with adjusted speeds ranging from 1,800 RPM to 2,400 RPM; 69% of patients managed to decrease their pump speed safely while 31% reached higher speeds before encountering complications.
  • - Caution is advised when altering pump speeds, especially in patients with poor right ventricular function, as individual responses varied significantly and issues like ventricular suction and tachycardia were observed in some cases.

Article Abstract

Third-generation continuous-flow left ventricular assist devices (LVAD) provide reduced pulsatility flow. We examined the safe working range for LVAD pump speed and the effect on pump output and cardiac function in 13 stable outpatients with VentrAssist-LVAD (Ventracor Ltd, Australia). Pump speed was decreased from a baseline mean of 2,073 ± 86 revolutions per minute (RPM, with corresponding mean flow of 5.59 ± 1.18 L/min, mean ± standard deviation) to an average low-speed of 1,835 ± 55 RPM (corresponding flow 4.68 ± 0.99 L/min) and up to high-speed of 2,315 ± 66 RPM (corresponding flow 6.30 ± 1.29 L/min). There was a strong linear relationship between alteration in speed and flow rates (r(2) = 0.89, p < 0.00001) but marked interpatient variation. Downward titration to preset minimum 1,800 RPM was achieved in 9/13 (69%) and upward titration to the preset maximum 2,400 RPM was achieved in 4/13 (31%). Upward titration was stopped due to ventricular suction or nonsustained ventricular tachycardia (VT) in 4/13 (31%). Ventricular suction or VT (in 4/13) tended to be more common in patients with poor right ventricular (RV) function (p = 0.07). In summary, pump flow is stable within a relatively small speed range and should not be altered without close monitoring due to variation in response between patients, particularly with concomitant RV impairment.

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Source
http://dx.doi.org/10.1097/MAT.0b013e318233b112DOI Listing

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