Ultraslow deflation automated sphygmomanometry in continuous-flow-left ventricular assist device patients

Left ventricular assist device (LVAD) is indicated for short- and long-term mechanical circulatory support. As hypertension is a risk factor for complications and unfavorable outcomes in LVAD recipients, blood pressure (BP) control is essential. Accurate measurement of BP can be challenging, as the degree of pulsatility and aortic valve opening can vary between patients. The ultraslow deflation automated sphygmomanometer, designed for those with a weak pulse and whose cuff deflation algorithm allows for the detection of a narrower pulse pressure, may be useful for accurate and simple BP measurement in continuous-flow-LVAD patients.

This pilot study assessed the accuracy and ease of use of the ultraslow deflation automated sphygmomanometer in both the in-patient and ambulatory clinical settings. Seven consecutive in-patients had arterial line monitoring and a HeartMate 3 (HM3) LVAD. All patients underwent 3 BP measurements with each modality at 3 separate times. In the outpatient setting, 11 consecutive patients (9 HM3 and 2 HeartWare HVAD) had mean arterial pressure (MAP) measurement using both Doppler RTF and ultraslow deflation automated sphygmomanometer.

There was no difference in mean MAP for each in-patient between modalities and across all patients based on BP measurement modality. In outpatients, there was no significant difference in MAP within each patient across modalities or users.

Ultraslow deflating sphygmomanometer appears to be reliable, accurate, and easy to use for BP monitoring in LVAD patients and may represent a more accessible and patient friendly method for BP management.