A novel flow waveform partitioning method based on the HeartCon and its clinical application

Left ventricular assist device (LVAD) is a crucial therapy for end-stage heart failure. This research aimed to validate the correspondence between the HeartCon flow waveform and the cardiac cycle through animal experiments and propose a novel electrocardiogram (ECG)-guided partitioning method. The controlled variable method was employed to systematically investigate the effects of varying rotational speeds, heart rates, and blood pressures on the HeartCon flow waveform and the cardiac cycle. The results demonstrated that the proposed HeartCon partitioning method exhibited higher accuracy in assessing ejection fraction (EF), with absolute relative errors below 5% when compared to echocardiography, significantly outperforming the HeartWare Ventricular Assist Device (HVAD)-based partitioning method (absolute relative errors exceeding 40%). Furthermore, the study revealed that the diastolic phase proportion was consistently less than 58% of that in a normal heart under various physiological conditions and further shortened with increased heart rate, elevated rotational speed, and decreased blood pressure, suggesting a potential significant impact of aspiration force produced by the pump on the diastolic phase. Based on the experimental findings, a HeartCon cardiac Wiggers diagram was constructed, clearly illustrating the temporal relationship and key characteristics of pump flow, left ventricular pressure, and aortic pressure after LVAD implantation. This novel flow waveform partitioning method provides a theoretical foundation for the clinical application of the HeartCon pump and offers new avenues for clinicians to monitor and assess patients’ physiological conditions through real-time flow waveforms. AI Assistance Declaration: During the preparation of this work, the authors used ChatGPT (OpenAI) to improve language and readability. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the publication's content.