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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Implantable physiologic controller for left ventricular assist devices with telemetry capability.

Siavash S Asgari1, Pramod Bonde1

  • 1Bonde Artificial Heart Laboratory, Department of Surgery, Yale School of Medicine, New Haven, Conn.

The Journal of Thoracic and Cardiovascular Surgery
|November 2, 2013
PubMed
Summary
This summary is machine-generated.

This study introduces a novel, wirelessly powered controller for left ventricular assist devices (LVADs), restoring pulsatile flow to improve patient outcomes. The system is safe, efficient, and offers a fully implantable solution for heart failure management.

Keywords:
27ECGEMFFREE-DFree-Range Resonant Electrical Energy DeliveryLVADMCLUMC-Physiodifference between systolic and diastolic pump speedselectrocardiographyelectromotive forceleft ventricular assist devicemock circulation looprevolutions per minuterpmultra-compact implantable physiologic controllerΔRPM

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Area of Science:

  • Biomedical Engineering
  • Cardiovascular Devices
  • Implantable Technology

Background:

  • Rotary left ventricular assist devices (LVADs) offer improved durability over pulsatile pumps but result in continuous flow, losing pulsatility.
  • This loss of pulsatility is linked to adverse outcomes, including gastrointestinal bleeding, aortic incompetence, and diastolic hypertension.
  • Existing LVAD systems often require a percutaneous driveline, increasing risks of infection and morbidity.

Purpose of the Study:

  • To develop and evaluate a novel, wirelessly powered, ultra-compact, implantable physiologic controller for LVADs.
  • To enable LVADs to operate in a pulsatile mode, addressing the limitations of continuous-flow devices.
  • To create a fully implantable system that eliminates the need for a percutaneous driveline.

Main Methods:

  • A circuit board schematic was designed for wireless power reception and LVAD operation, incorporating safety and backup measures.
  • An embedded antenna and wireless network were integrated for telemetry and control.
  • The controller underwent rigorous testing in both in vitro and in vivo experimental setups.

Main Results:

  • The controller successfully operated LVADs continuously for two weeks in vitro and in vivo without failure.
  • The novel controller demonstrated superior power efficiency compared to current FDA-approved LVAD controllers.
  • Electrocardiography synchronization enabled on-demand customization, achieving pulsatile flow with adjustable pulse pressure.

Conclusions:

  • The developed system is safe, accurate, and efficient for driving LVADs.
  • Wireless power delivery and a compact design make this controller an ideal component for a totally implantable LVAD system.
  • This technology has the potential to significantly improve LVAD therapy by restoring pulsatility and enhancing patient safety.