Effect of Exercise and Pump Speed Modulation on Invasive Hemodynamics in Patients with Centrifugal Continuous Flow Left Ventricular Assist Devices [1]
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?