Table 3.

Different LVAD device characteristics and subsequent different emergency management.

Information/devices	Heart MATE 3 / II	Heartware	Jarvik 2000
Mechanism	Centrifugal pump with full magnetic levitation of the rotor / axial continue–flow pump	Centrifugal flow pump	Axial continue–flow pump
Pulse	Normally absent or weak	Normally absent or weak	It could be present depending on myocardial contraction, preload, and afterload
Target vital signs	mBP 70–90 mmHg	mBP 75–90 mmHg (preferably use the doppler method to measure BP)	mBP 65–75 mmHg
Low–flow advices	Heart–shaped red light will appear with a continuous acoustic alarm	Triangular yellow light with acoustic alarm	Low–flow –> Light alarm Pump arrest –> stop signal with red bell and continuous acoustic alarm
Low–flow treatment	Hypovolemia –> fluid administration Right HF –> inotropes, fluids, hyperventilation	Evaluate if volume expansion is required
Device flow velocity	Impossible to speed up in out–of–hospital environment	Impossible to speed up in out–of–hospital environment	Normally set on 3 velocity, it could be manually adjusted
Heparin therapy	Generally, not required (discuss with LVAD implantation center)	To decide whether to use heparin, contact LVAD implantation center	Generally, not necessary
Defibrillation	Possible	Possible (don't disconnect device before delivering current)	Possible (don't disconnect device before delivering current)
External or manual pump	Not present	Not present With ECM, high risk of device displacement: evaluate on clinical basis. If ECM has to be performed, evaluate pump function and position first	Not present ECM Possible
External pacing	Possible	Possible	Possible
External cables	One cable emerges from abdomen	One cable emerges from abdomen	One cable emerges from retro–auricular area or abdomen
Battery supply	Patient should have already been equipped with a set of black batteries (3 h duration) and gray batteries (14–17 / 8–10 h duration; charge conditions could be checked pressing the button on the battery cover) –>At least ONE cable must always be connected to a power generator: DON'T remove simultaneously the two batteries, otherwise the pump will stop	Device receive charge from one battery at a time: maximum duration 4–6 h (Both battery and controller have a light signal indicating charge status)	Only battery power source (not electrical current) 2 types of battery: Small and portable, 8–10 h duration (could be quantified pressing on the black button on the battery) Big supply battery, minimum 24 h duration

ECM, external cardiac massage; HF, heart failure; LVAD, left ventricular assist device; mBP, mean blood pressure.