Windkessel model of hemodynamic state supported by a pulsatile ventricular assist device in premature ventricle contraction

Autor: Seong Wook Choi, Ki Moo Lim, Joon Yeong Kim, Keun Her
Rok vydání: 2018
Předmět:
Male
Windkessel model
medicine.medical_treatment
Pulsatile flow
Hemodynamics
Blood Pressure
02 engineering and technology
030204 cardiovascular system & hematology
Electrocardiography
0302 clinical medicine
Heart Rate
Tachycardia
Medicine
Radiological and Ultrasound Technology
Cardiac cycle
Models
Cardiovascular
General Medicine
Middle Aged
Ventricular Premature Complexes
lcsh:R855-855.5
Pulsatile Flow
cardiovascular system
Aortic pressure
Cardiology
Female
medicine.symptom
Arrhythmia
Algorithms
Adult
medicine.medical_specialty
lcsh:Medical technology
Sinus tachycardia
Heart Ventricles
0206 medical engineering
Biomedical Engineering
Phase-locked loop
Biomaterials
Counter-pulsation control
Young Adult
03 medical and health sciences
Internal medicine
Pulsatile ventricular assist device
Heart rate
Humans
Computer Simulation
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Aged
Heart Failure
business.industry
Research
Arrhythmias
Cardiac
medicine.disease
Myocardial Contraction
020601 biomedical engineering
Ventricular assist device
Heart failure
Heart-Assist Devices
business
Zdroj: BioMedical Engineering
BioMedical Engineering OnLine, Vol 17, Iss 1, Pp 1-13 (2018)
ISSN: 1475-925X
DOI: 10.1186/s12938-018-0440-5
Popis: Background Counter-pulsation control (CPC) by ventricular assist devices (VADs) is believed to reduce cardiac load and increase coronary perfusion. However, patients with VADs have a higher risk of arrhythmia, which may cause the CPC to fail. Consequently, CPC has not been applied by VADs in clinical practice. The phase-locked loop (PLL) algorithm for CPC is readily implemented in VADs; however, it requires a normal, consistent heartbeat for adequate performance. When an arrhythmia occurs, the algorithm maintains a constant pumping rate despite the unstable heartbeat. Therefore, to apply the PLL algorithm to CPC, the hemodynamic effects of abnormal heartbeats must be analyzed. Objectives This study sought to predict the hemodynamic effects in patients undergoing CPC using VADs, based on electrocardiogram (ECG) data, including a wide range of heart rate (HR) changes caused by premature ventricular contraction (PVC) or other reasons. Methods A four-element Windkessel hemodynamic model was used to reproduce the patient’s aortic blood pressure in this study. ECG data from 15 patients with severe congestive heart failure were used to assess the effect of the CPC on the patients’ hemodynamic state. The input and output flow characteristics of the pulsatile VAD (LibraHeart I, Cervika, Korea) were measured using an ultrasound blood flow meter (TS410, Transonic, USA), with the aortic pressure maintained at 80–120 mmHg. All other patient conditions were also reproduced. Results In patients with PVCs or normal heartbeats, CPC controlled by a VAD reduced the cardiac load by 20 and 40%, respectively. When the HR was greater for other reasons, such as sinus tachycardia, simultaneous ejection from the heart and VAD was observed; however, the cardiac load was not increased by rapid cardiac contractions resulting from decreased left ventricle volume. These data suggest that the PLL algorithm reduces the cardiac load and maintains consistent hemodynamic changes.
Databáze: OpenAIRE
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