Verbeni Antonella, Fontana Rossella, Silvestri Michele, Tortora Giuseppe, Vatteroni Monica, Trivella Maria Giovanna, Dario Paolo
IEEE Trans Biomed Circuits Syst. 2014 Oct;8(5):660-8. doi: 10.1109/TBCAS.2014.2346015. Epub 2014 Sep 11.
Nowadays advanced heart failure is mainly treated through heart transplantation. However, the low availability of donors makes the research of alternative therapies urgent. Continuous-flow left ventricular assist devices (LVADs) are going to assume a more significant role in assisting the failing heart. A recent challenge in clinical practice is the possibility to use LVAD as long-term therapy rather than as a bridge to transplantation. For this reason, more comfortable devices, able to dynamically adapt to the physiological cardiac demand in relation to the patient activity level, are needed in order to improve the life quality of patients with implants. Nevertheless, no control system has been developed yet for this purpose. This work proposes an innovative control strategy for a novel sensorized LVAD, based on the continuous collection of physical and functional parameters coming from implantable sensors and from the LVAD itself. Thanks to the proposed system, both the patient and the LVAD conditions are continuously monitored and the LVAD activity regulated accordingly. Specifically, a Proportional Integrative (PI) and a threshold control algorithms have been implemented, respectively based on flow and pressure feedbacks collected from the embedded sensors. To investigate the feasibility and applicability of this control strategy, an on-bench platform for LVADs sensing and monitoring has been developed and tested.
如今,晚期心力衰竭主要通过心脏移植进行治疗。然而,供体的低可用性使得替代疗法的研究变得紧迫。连续流左心室辅助装置(LVAD)在辅助衰竭心脏方面将发挥更重要的作用。临床实践中最近面临的一个挑战是能否将LVAD用作长期治疗手段,而非移植的桥梁。因此,需要更舒适的装置,能够根据患者活动水平动态适应生理心脏需求,以提高植入患者的生活质量。然而,目前尚未为此目的开发控制系统。这项工作为一种新型的带有传感器的LVAD提出了一种创新的控制策略,该策略基于持续收集来自植入式传感器和LVAD本身的物理和功能参数。得益于所提出的系统,患者和LVAD的状况都能得到持续监测,并据此调节LVAD的活动。具体而言,分别基于从嵌入式传感器收集的流量和压力反馈,实现了比例积分(PI)和阈值控制算法。为了研究这种控制策略的可行性和适用性,开发并测试了一个用于LVAD传感和监测的实验平台。