Background: When using a pulsatile left ventricular assist device (LVAD), it is\r\nimportant to reduce the cardiac load variations of the native heart because severe\r\ncardiac load variations can induce ventricular arrhythmia. In this study, we\r\ninvestigated the effect of counter-pulsation control of the LVAD on the reduction of\r\ncardiac load variation.\r\nMethods: A ventricular electrocardiogram-based counter-pulsation control algorithm\r\nfor a LVAD was implemented, and the effects of counter-pulsation control of the\r\nLVAD on the reduction of the working load variations of the left ventricle were\r\ndetermined in three animal experiments.\r\nResults: Deviations of the working load of the left ventricle were reduced by 51.3%,\r\n67.9%, and 71.5% in each case, and the beat-to-beat variation rates in the working load\r\nwere reduced by 84.8%, 82.7%, and 88.2% in each ease after counter-pulsation control.\r\nThere were 3 to 12 premature ventricle contractions (PVCs) before counter-pulsation\r\ncontrol, but no PVCs were observed during counter-pulsation control.\r\nConclusions: Counter-pulsation control of the pulsatile LVAD can reduce severe cardiac\r\nload variations, but the average working load is not markedly affected by application of\r\ncounter-pulsation control because it is also influenced by temporary cardiac outflow\r\nvariations. We believe that counter-pulsation control of the LVAD can improve the\r\nlong-term safety of heart failure patients equipped with LVADs.
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