Blood-pressure Measuring in Patients Carrying a Left Ventricular Assist Device

The number of patients supported by left ventricular assist device (LVAD) is increasing as durable mechanical support has become widely available for end stage heart failure as destination therapy and as bridge to transplantation. The accurate measurement of blood pressure (BP) as well as the recognition and management of hypertension in patients with LVADs is an essential component of optimal clinical care. Hypertension is an established long-term risk factor for cardiovascular disease. The measurement of BP and the management of hypertension in patients with CF-VADs can present unique challenges. Patients with LVADs often do not have a palpable pulse, and therefore traditional BP measurement by auscultation or automated cuff is less reliable. Conventional occlusive BP measurement is able to to pick up signals in approximately 50% of cases due to coincidental phases of pulsatility. The arterial line is the gold standard, but is an invasive procedure and not practical for routine outpatient use.

Although efforts are underway to identify an easier and more reliable method to measure ambulatory BP in these patients not one has been able to match the quality of an invasive arterial line.

Inclusion criteria

• Patients carrying one of the two third generation CF-VADS (Heartware HVAD, Heartmate 3)
• Patients >18y
• Good understanding of written and oral German
• Signed informed consent
• Scheduled for routine outpatient appointment.

Exclusion criteria

• In the population of the outpatient clinic's CV-LVAD patients no known exclusion criteria exists