Direct cardiac potential trigger for chronic control of a ventricular assist device

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Medical Devices

Background:

• Ventricular assist devices (VADs) require reliable triggering for optimal function.
• Standard electrocardiogram (ECG) triggers can be susceptible to artifacts, compromising VAD performance.
• A novel trigger method is needed for stable, chronic VAD support.

Purpose of the Study:

• To evaluate a direct cardiac potential trigger as a new method for chronic VAD drive control.
• To assess the reliability of this trigger under various challenging conditions in an experimental model.

Main Methods:

• A pneumatic pulsatile VAD was implanted in 12 adult pigs.
• Direct cardiac potentials were recorded using bipolar electrodes on the right and left ventricles.
• VAD counterpulsation was controlled using either standard ECG R-wave or direct cardiac potential triggers.
• Simulated artifacts including irregular ventilation, passive vibration, and arrhythmias were introduced.

Main Results:

• Standard ECG triggers showed poor VAD control with artifacts from irregular ventilation and passive vibration.
• The direct cardiac potential trigger consistently maintained effective VAD counterpulsation control across all tested conditions.
• This trigger method proved safe and reliable, supporting animals for up to 48 hours post-operation.

Conclusions:

• Direct cardiac potential triggering is a safe and reliable method for chronic VAD control.
• This method effectively monitors native heartbeats and synchronizes VAD support.
• It shows promise as a superior chronic control strategy for various VADs.