Here are resources that will help prepare community healthcare service providers for encounters with patients who have an LVAD implant. This includes home health providers, dialysis centers, cardiac rehab and sub-acute rehab, LTAC EMS services and emergency departments.

HeartMate Device Management
  • Power (approximately 3-7watts): Values greater than 10–12 watts not related to increased flow may indicate presence of thrombus, increased intrathoracic pressure or HTN, Call if power doubles from baseline or increases to greater than 10 and stays elevated.
  • Flow (approximately 3–7 L/min): It is an estimated number based on power and speed. Normal flow is patient-specific and based on cardiac output needs. Flow decreases may indicate decrease in patient volume status.
  • Speed: Pump speed is set (usually HM2 8,200–9,800rpm, HM3 4800–7000rpm). The speed of a Heartmate 3 increases and decreases by 2000rpm, 30 times a minute to create a little Pulsatility and wash out the pump to decrease incidence of thrombus and lower risk of stroke. 
  • Pulsatility Index (PI) (approximately 3–7): This fluctuates with changes in demand and volume status.  A significant drop in PI may indicate a decrease in blood volume. A significant increase in PI may indicate hypertension.
Guidelines for LVAD Patients

Treat the patient, not the VAD!

Follow ACLS algorithms.  May do chest compressions if there is no perfusion

  • Always assess for signs of perfusion in case of no pulse.
  • Listen for pump to assess if it is running.
  • If pump not running, check all connections and power sources.
  • DO NOT disconnect System Controller prior to external defibrillation.
  • Place Defib pads anterior/posterior.
  • DO NOT DISCONNECT both System Controller power sources at same time.
  • Heartmate LVADs are non-pulsatile continuous flow devices. Patient’s pulse may not be palpable.
  • Check EKG, HR, BP, labs (hgb), chest tubes, fluid status, Cardiac Output……
  • Patient must have backup bag with backup controller and extra batteries with them at all times.
Arrhythmias
  • LVAD patients are a greater risk for ventricular arrhythmias. This is partly due to the presence of the inflow cannula in the LV. 
  • Many patients with an LVAD will also have an ICD/pacer. They can be shocked from the ICD. 
  • Ventricular tachycardia and ventricular fibrillation may not cause immediate hemodynamic instability and loss of consciousness, as the LV is being supported with the LVAD. It is important to resume a stable rhythm as soon as possible to prevent hemodynamic deterioration.
  • All LVAD patients can be cardioverted/defibrillated without stopping or disconnecting the LVAD. Chest compressions may be done if there is a lack of perfusion.

How to refer a patient

Referring to our LVAD Program is simple and streamlined. Our coordinators are available to guide you through every step.

  • Phone: 770-219-9905 (LVAD Coordinator)
  • Fax: 770-219-9049

For urgent referrals, please call our team directly at 770-219-9905 to connect with a coordinator immediately and start the process. 

NGHS Advantages

Fast Turnaround: Patients are evaluated promptly, with most decisions made within 48 hours.

Support for Providers: You’ll have direct access to our LVAD coordinators, with smooth communication and updates throughout the process.