Lived experiences of patients using left ventricular assist devices (LVADs): a systematic review of qualitative studies

Abstract Background Left ventricular assist devices (LVADs) represent a transformative intervention for advanced heart failure patients, serving as bridge-to-transplantation or destination therapy. While clinical outcomes are well-documented, understanding patients’ lived experiences is essential for delivering patient-centered care. Objective To systematically identify, analyze, and synthesize qualitative research examining the lived experiences of heart failure patients with LVADs, encompassing physical, emotional, psychological, social, and existential dimensions. Methods PubMed, Scopus, Science Direct, and Google Scholar were searched (January 2011-September 2025). Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) checklist, risk of bias using an adapted Cochrane tool, and certainty of evidence using GRADE-CERQual. Thematic synthesis identified recurring patterns across studies. Results Eighteen qualitative studies involving 345 participants (275 patients, 70 caregivers) across nine countries met inclusion criteria. Eight themes emerged: physical and functional dimensions; emotional-psychological dimensions including anxiety, depression, and post-traumatic growth; hope and optimism; social relationship transformation; adaptation and coping mechanisms; holistic support systems; liminality and identity reconstruction; and technology integration and device burden. Risk of bias was generally low to moderate. GRADE-CERQual indicated high confidence for physical, emotional, and support themes, with moderate confidence for existential aspects. Studies predominantly originated from the United States with limited non-Western representation. Discussion LVAD recipients face complex existential challenges requiring multidisciplinary support beyond medical management. Findings underscore the necessity for comprehensive care models addressing psychosocial adaptation, identity reconstruction, and quality of life. The predominance of studies from high-income Western countries limits transferability. Future longitudinal research with targeted recruitment of underrepresented populations is needed. PROSPERO registration number CRD420251181600.