Early detection of HVAD pump thrombosis based on technical analysis and power consumption measurements
Funding information
This work was supported by the RH ROT project realized in our institution (STRATEGMED2/266798/15/NCBR/2015)
Abstract
Background
Continuous-flow left ventricular assist devices (LVADs) have been extensively used in a strategy of bridge to orthotopic heart transplant and destination therapy. The usage of LVAD, however, is not free from limitations such as device-related adverse events, including pump thrombosis (PT). We aimed to develop an algorithm of early PT detection based on the maintenance parameters monitored by the implanted device.
Methods
We analyzed log files of 101 patients implanted with HeartWare pump (HVAD) with 18 PT events among them. For signal processing, we used the open-high-low-close format transformation and typical price (TP) technical analysis indicator. Model parameters were tuned with 5-fold cross-validation, and the final performance was measured on a separate group of patients.
Results
Our algorithm achieved 100% sensitivity and 100% specificity of indications. In the final evaluation, alarms preceded the clinical acknowledgement of events by 2 days and 20 h on average. In the worst-case scenario, an alarm was raised 1 day and 8 h prior to the event.
Conclusions
The proposed algorithm could be installed to work directly with the device controller and provide clinicians with automatic readings analysis, raising an alarm when there is a high probability of thromboembolism. Early event detection could enable better thrombosis management and improve prognosis in patients implanted with HVAD.
CONFLICT OF INTEREST
Maciej Gawlikowski: Other Advisory Board Member; Current/Ongoing – Payment Made to My Institution; Symico sp z o.o. Agencja Naukowo Techniczna, Powstańców Śląskich 54a, 53-332 Wrocław.
