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Effect of Exercise and Pump Speed Modulation on Invasive Hemodynamics in Patients with Centrifugal Continuous Flow Left Ventricular Assist Devices

Monday, November 10, 2014

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Source Name: Journal of Heart and Lung Transplantation


Kavitha Muthiah, Desiree Robson, Roslyn Prichard, Robyn Walker, Sunil Gupta, Anne M Keogh, Peter S Macdonald, John Woodard, Eugene Kotlyar, Kumud Dhital, Emily Granger, Paul Jansz, Phillip Spratt, Christopher S Hayward

The effects of exercise, increasing pump speed, or both on invasive hemodynamics in centrifugal flow LVAD patients were analyzed in this small study.  Findings included:

  • Increasing pump speed at rest increased pump flow and decreased PCWP.
  • Exercise increased pump flow but yielded increased right and left-sided filling pressures.
  • Exercise combined with increased pump speed increased pump flow further (synergistic effect) without lowering right- and left-sided filling pressures.

Questions raised:

  • What should be done to improve unloading in LVAD patients during exercise?
  • Should algorithms be included in the LVAD that automatically uptitrate RPMs during exercise?
  • Would increasing pump speeds further, beyond manufacturer's recommendations, safely improve unloading during exercise?

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