Sleeping prone with a left ventricular assist device: Dream or reality?

Area of Science:

• Cardiology
• Medical Devices
• Patient Quality of Life

Background:

• Restrictions on sleeping positions can negatively impact quality of life for patients with durable left ventricular assist devices (LVADs).
• Current recommendations typically prohibit sleeping in the prone position due to concerns about driveline issues, infections, and hemodynamic instability.
• Limited data exist to support these contraindications, with no prior studies examining sleep positions in LVAD recipients.

Observation:

• A 38-year-old male HeartWare™ LVAD recipient secretly slept in the prone position nightly for 16 months post-implantation.
• The patient experienced no device malfunctions, infections, neurological issues, or hemodynamic compromise during this period.
• Non-invasive hemodynamic assessments were conducted in both supine and prone positions to evaluate the effects of prone sleeping.

Findings:

• The patient's prolonged prone sleeping did not result in any reported adverse device-related events.
• Hemodynamic assessments provided insights into the physiological effects of the prone position in this LVAD patient.

Implications:

• Sleeping in the prone position may be safely tolerated in select patients with left ventricular assist devices.
• These findings challenge existing recommendations and suggest a potential need for personalized guidance on sleep positioning for LVAD recipients.
• Further research is warranted to explore the safety and hemodynamic implications of various sleep positions in a larger LVAD population.