Detection of inflow obstruction in left ventricular assist devices by accelerometer: An in vitro study.

Autor: Lilja D; The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: didlil@ous-hf.no., Schalit I; The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Espinoza A; The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway., Pettersen FJ; Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway; Department of Physics, University of Oslo, Norway., Elle OJ; The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway; Department of Informatics, The University of Oslo, Norway., Halvorsen PS; The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Jazyk: angličtina
Zdroj: Medical engineering & physics [Med Eng Phys] 2022 Dec; Vol. 110, pp. 103917. Date of Electronic Publication: 2022 Nov 08.
DOI: 10.1016/j.medengphy.2022.103917
Abstrakt: Inflow obstruction in left ventricular assist devices (LVAD) may lead to embolic stroke and pump malfunction. We investigated if an accelerometer detected graded LVAD inflow obstructions. Detection performances were compared to the current continuous surveillance routine based on the pump power consumption (P LVAD ). In ten mock circuit experiments, four different-sized pendulating balloons obstructed HVAD™ inflow conduits cross-section areas by 14%-75%. Nonharmonic amplitudes (NHA) of continuous signals from a triaxial accelerometer attached to the LVAD were compared against single-point P LVAD values, using load and speed alterations as control interventions. We analyzed the NHA band power with a pairwise nonparametric statistical test. The detection performances were analyzed by receiver operating characteristics with areas under the curves (AUC). The NHA remained unaffected during load alterations. In contrast, NHA increased significantly from the 27% obstruction level (AUC≥0.82), an effect amplified by increased pump speed. P LVAD did not change significantly below the maximal 75% obstruction level (AUC≤0.36). In conclusion, NHA detected the inflow obstructions much better than P LVAD . The technique may provide a future monitoring modality of any pendulating obstructive inflow pathology.
Competing Interests: Declaration of Competing Interest The company Cardiaccs AS has a patent approved in the EU, also pending approval in the US, on the idea of using an accelerometer in the monitoring of LVADs. The authors Halvorsen, Espinoza, and Elle are shareholders in the company. We report no other conflict of interest.
(Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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