Improved Detection Of Thromboembolic Complications In Left Ventricular Assist Device By Novel Accelerometer-Based Analysis.

Autor:	Schalit I; From the The Intervention Centre, Oslo University Hospital.; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital.; Institute of Clinical Medicine University of Oslo, Norway., Espinoza A; From the The Intervention Centre, Oslo University Hospital.; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital., Pettersen FJ; Department of Cardiology, Oslo University Hospital., Skulstad H; Department of Clinical and Biomedical Engineering Oslo University Hospital, Oslo University Hospital., Fosse E; From the The Intervention Centre, Oslo University Hospital.; Institute of Clinical Medicine University of Oslo, Norway., Fiane AE; Department of Cardiothoracic Surgery, Oslo University Hospital.; Institute of Clinical Medicine University of Oslo, Norway., Halvorsen PS; From the The Intervention Centre, Oslo University Hospital.; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital.; Institute of Clinical Medicine University of Oslo, Norway.
Jazyk:	angličtina
Zdroj:	ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2022 Sep 01; Vol. 68 (9), pp. 1117-1125. Date of Electronic Publication: 2022 Jan 19.
DOI:	10.1097/MAT.0000000000001654
Abstrakt:	We have previously demonstrated that accelerometer-based vibration analysis detects thromboembolism and pump thrombosis in HeartWare Left Ventricular Assist Device (HVAD) using the third harmonic frequency (pump_speedx3). Thromboembolism also affected the amplitude of the nonharmonic frequencies. The aim of this study was to determine whether nonharmonic-amplitude (NHA) analysis can improve the diagnosis of thromboembolic complications. An accelerometer was attached to HVAD in three in vitro and seven in vivo experiments. Control interventions, including load and pump speed alternations (n = 107), were followed by thromboembolic events (n = 60). A sliding fast-Fourier-transform was analyzed, and changes in NHAs were quantified in the acute phase and in a steady state. Receiver operating characteristic curves were constructed with cutoff values of NHA to detect thromboembolic events. Positive predictive values were calculated on the basis of a specificity of 1. In the acute phase, NHA change was 6.5 times higher under thromboembolism than under control interventions (p < 0.001). Most thromboembolic events lead to concomitant changes in both NHA and third-harmonic amplitude. Combining the two methods improved the PPV by 8.3%. At steady state, signal changes predominantly demonstrated either NHA or third-harmonic changes. Combined signal analysis improved the PPV by 36%. This method enhanced the detection of thromboembolism and pump thrombosis in the HVAD. Competing Interests: The research was funded by the South-Eastern Norway Regional Health Authority. The company Cardiacs AS has a pending patent on the idea of using accelerometer in pump thrombosis detection. The authors Halvorsen, Espinoza, and Fosse are shareholders in the company. We report no other conflicts of interest. (Copyright © ASAIO 2022.)
Databáze:	MEDLINE
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