Abstract 11151: Vascular Pulsatility During Mechanical Actuation of the Fibrillating Heart is Equivalent to the Native Beating Heart
Introduction: Direct Mechanical Ventricular Actuation (DMVA) is a non-blood-contacting direct cardiac compression device shown to resuscitate both humans and animals without myocardial injury. The purpose of this study was to determine if DMVA support during ventricular fibrillation (VF) generates pulsatility similar to the native heart.
Methods: Large canine (n=10) and swine (n=10) were anesthetized, underwent sternotomy, and instrumented for hemodynamic monitoring and intracardiac echocardiography. VF was induced for 5 mins of circulatory arrest and DMVA applied for 15 mins. Hearts were then defibrillated and allowed to recover. Repeated periods of arrest were used to increase cardiac dysfunction post-resuscitation. Paired t-tests were used to compare the post-sternotomy baseline, supported VF, and unsupported post-resuscitation states. Mean pressures and flows were statistically equalized between supported arrest and unsupported post-resuscitation. Previously described metrics of pulsatility were calculated using 10 sec flow and pressure intervals.
Conclusions: DMVA was able to generate physiologic levels of pulsatility even during support of the fibrillating heart across a range of heart sizes. Differences in overall energy (EEP) between the possibly hyperdynamic baseline and support can be explained by discrepancies in mean (continuous) pressures and flows given observed similarities in the pulsatile component (PP, PI, SHE). Mechanical actuation of the fibrillating heart was shown to provide superior pulsatility compared to post-resuscitation hearts with comparable hemodynamic means and power curves.
Author Disclosures: B.A. Schmitt: None. N.V. Wright: None. Y. Zhou: None. D.B. Reynolds: None. M.P. Anstadt: None.
- © 2016 by American Heart Association, Inc.