Generating artificial pulse
A mechanical circulatory assist system includes a continuous-flow pump and a controller. The pump is implantable to assist blood flow from the left ventricle to the aorta The controller is operable to control a rotation speed of the pump over an operational cycle. The operational cycle includes a first segment over which the ventricular assist device is operated at first rotation speed, a second segment over which the rotation speed of the ventricular assist device is decreased from the first rotation speed to a second rotation speed, a third segment over which the ventricular assist device is operated at the second rotation speed, and a fourth segment over which the rotation speed of the ventricular assist device is increased from the second rotation speed. A contraction of the left ventricle that opens and closes the native aortic valve occurs during the third segment.
1. A mechanical circulatory assist system comprising:
a continuous-flow pump implantable in fluid communication with a left ventricle of a patient's heart and an aorta of the patient to assist blood flow from the left ventricle to the aorta; and
a controller operatively connected to the continuous-flow pump and operable to control a rotation speed of the continuous-flow pump over an operational cycle that comprises:
a first segment over which the continuous-flow pump is operated in an artificial pulse mode;
a second segment over which operation of the continuous-flow pump is transitioned from the artificial pulse mode to a pump speed pattern that produces a reduced blood flow rate that accomodates generation of a blood flow rate by the patient's heart, which produces opening of a native aortic valve of the patient;
a third segment over which the continuous-flow pump is operated in the pump speed pattern that produces the reduced blood flow rate, and
a fourth segment over which operation of the continuous-flow pump is transitioned from the pump speed pattern that produces the reduced blood flow rate to the artificial pulse mode.
2. The mechanical circulatory assist system of claim 1 , wherein the controller is operable to control the continuous-flow pump to repeat the operational cycle.
3. The mechanical circulatory assist system of claim 2 , wherein the controller is operable to control the continuous-flow pump to repeat the operational cycle independent of heart activity of the patient.
4. The mechanical circulatory assist system of claim 1 , wherein the first segment occurs over an indefinite period of time independent of heart activity of the patient.
5. The mechanical circulatory assist system of claim 1 , wherein the controller comprises:
a waveform generator to generate a waveform for controlling the rotation speed of the continuous-flow pump; and
a drive waveform transmitter to supply the generated waveform to the continuous-flow pump.
6. The mechanical circulatory assist system of claim 1 , wherein the continuous-flow pump is operated at a constant rotation speed in the pump speed pattern that produces the reduced blood flow rate.
7. A mechanical circulatory assist system comprising:
a continuous-flow pump implantable in fluid communication with a left ventricle of a patient's heart and an aorta of the patient to assist blood flow from the left ventricle to the aorta; and
a controller operatively connected to the continuous-flow pump and operable to control the continuous-flow pump to generate a blood flow pattern that produces opening of a native aortic valve of the patient, the controller repeating an operational cycle in which the controller controls a rotation speed of the continuous-flow pump to:
operate the continuous-flow pump in an artificial pulse mode over a first period of time,
transition operation of the continuous-flow pump from the artificial pulse mode to a rotation speed that produces a reduced blood flow rate that accomodates generation of a blood flow rate by the patient's heart, which produces opening of a native aortic valve of the patient,
operate the continuous-flow pump at the rotation speed that produces the reduced blood flow rate over a second period of time, and
increase the rotation speed of the continuous-flow pump from the rotation speed that produces the reduced blood flow rate.
8. The mechanical circulatory assist system of claim 7 , wherein a left ventricular relaxation occurs during the first period of time.
9. The mechanical circulatory assist system of claim 7 , wherein the controller repeats the operational cycle independent of heart activity of the patient.
10. The mechanical circulatory assist system of claim 7 , wherein the rotation speed of the continuous-flow pump is gradually decreased from the artificial pulse mode to the rotation speed that produces the reduced blood flow rate over a first transitional period of time that does not encompass any period of time during which the rotation speed of the continuous-flow pump is increased.
11. The mechanical circulatory assist system of claim 7 , wherein the rotation speed of the continuous-flow pump is increased from the rotation speed that produces the reduced blood flow rate to the artificial pulse mode over a second transitional period of time that does not encompass any period of time during which the rotation speed of the continuous-flow pump is decreased.
12. A method of controlling a rotation speed of a ventricular assist device to produce opening of a native aortic valve of a patient, the method comprising controlling, via a controller, the ventricular assist device over an operational cycle that comprises:
a first segment over which the ventricular assist device is operated in an artificial pulse mode;
a second segment over which operation of the ventricular assist device is transitioned from the artificial pulse mode to a rotation speed that produces a reduced blood flow rate that accommodates generation of a blood flow rate by the patient's heart;
a third segment over which the ventricular assist device is operated at the rotation speed that produces the reduced blood flow rate, wherein a contraction of the left ventricle that opens and closes the native aortic valve occurs during the third segment, and
a fourth segment over which the rotation speed of the ventricular assist device is increased from the rotation speed that produces the reduced blood flow rate.
13. The method of claim 12 , further comprising controlling, via the controller, the ventricular assist device to repeat the operational cycle.
14. The method of claim 13 , wherein the operational cycle is repeated independent of heart activity of the patient.
15. The method of claim 12 , wherein the first segment is occurs over an indefinite period of time independent of heart activity of the patient.
16. The method of claim 12 , wherein the controlling of the rotation of the ventricular assist device, by the controller, over the operational cycle comprises:
generating a waveform for controlling the rotation speed of the ventricular assist device; and
supplying the waveform to the ventricular assist device.
17. The method of claim 12 , wherein the rotation speed that produces the reduced blood flow rate is a constant speed selected by a clinician.
18. The method of claim 12 , wherein the rotation speed of the ventricular assist device is increased from the rotation speed that produces the reduced blood flow rate to a constant rotation speed in the fourth segment.