Interventricular dyssynchrony during continuous-flow left ventricular assist device support: observation using the conductance method

• Published in: Journal of artificial organs Vol. 22; no. 4; pp. 348 - 352
• Main Authors: Shimamura, Junichi, Nishimura, Takashi, Mizuno, Toshihide, Takewa, Yoshiaki, Tsukiya, Tomonori, Inatomi, Ayako, Katagiri, Nobumasa, Ando, Masahiko, Umeki, Akihide, Akiyama, Daichi, Arakawa, Mamoru, Ono, Minoru, Tatsumi, Eisuke
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.12.2019; Springer Nature B.V
• Subjects: Anesthesia; Animals; Biomedical Engineering and Bioengineering; Body weight; Brief Communication; Cardiac Surgery; Catheters; Conductance; Continuous flow; Diastole; Disease Models, Animal; Electrocardiography; Goats; Heart; Heart Failure - physiopathology; Heart Failure - surgery; Heart Ventricles - physiopathology; Heart-Assist Devices - adverse effects; Medical instruments; Medicine; Medicine & Public Health; Nephrology; Phase transitions; Resistance; Systole; Ventricle; Ventricular Dysfunction, Right - etiology; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Right - physiology; Left ventricular assist device; Pressure–volume loop; Interventricular dyssynchrony; Conductance method
• ISSN: 1434-7229; 1619-0904
• DOI: 10.1007/s10047-019-01115-5

The purpose of this study was to observe and clarify the interventricular dysscynchrony caused by continuous-flow left ventricular assist device (CF-LVAD) support using the conductance method. During CF-LVAD support, the systolic phase of the left ventricle (LV) becomes shorter than that of the right ventricle (RV). Accordingly, timing of the systole and diastole during the cardiac cycle is not synchronous between the LV and RV. In this study, we evaluated this phenomenon in a normal heart model using the adult goat ( n  = 5, body weight 44.5 ± 2.9 kg). A centrifugal LVAD was implanted under general anesthesia. We inserted the conductance catheter into the RV and LV to obtain the pressure–volume relationship of the two ventricles simultaneously. We defined the dyssynchronous status as the sign (plus or minus) of the LV volume-change opposite to that of RV volume-change. Dyssynchronous phase of the cardiac cycle was observed in 5.6 ± 0.65% of hearts under LVAD pump-off and 25.3 ± 3.3% under LVAD full bypass, respectively ( p  < 0.05). To the best of our knowledge, this is the first experimental report clarifying interventricular dyssynchrony during CF-LVAD support using the conductance method. Quantification of this phenomenon under various support conditions and assessment of influences on the right ventricular function will be studied in future studies.