FUTURE HEART PUMPS COULD BE CHOICE NO. 1

Today Abbott's HeartMate 3 heart pump performs nearly as well as heart transplants, and the future is even brighter.

Heart pumps of the future will be even more appealing

Jun 10 2019

For people who need new hearts, machine may soon eclipse Mother Nature.

There are a very limited number of hearts available for transplant in any given year, generating a very real issue for the more than 5.7 million people in the U.S. living with heart failure who could benefit from a transplant. As a result, many take advantage of mechanical heart pump technology that can improve their lives right now rather than sitting on a long transplant wait list.

That mechanical technology is rapidly improving. In terms of health outcomes, the latest data suggests patients with a HeartMate 3 left ventricular assist device (LVAD) had survival rates through two years nearly equivalent to those who received a heart transplant. Could machines become the preferred choice for a new heart in the future?

"We're a lot closer to that reality than most people think," said Kevin Bourque, vice president of research and development for the mechanical circulatory support business at Abbott. "Transplants aren't magic; they can create some real complications. The rate of improvements on the pump technology and maintenance means it's not unreasonable to think that patients who have a choice would start picking the device as their 'forever heart' over a spot on the heart transplant wait list."

Encouraging results for pumps

The most recent results from studies on HeartMate 3 show encouraging signs for people living with heart failure; improved long-term survival, higher quality of life and lowered chances of strokes and blood clotting. HeartMate 3 LVAD is built to last, and its Full MagLev technology is designed to pump blood efficiently without damaging the blood cells.

Having a heart pump today means people living with them must manage some of the technology. There's a driveline connected to the internal pump that extends outside the body to keep the device powered and running properly. But the next iterations of heart pumps are expected to remove that external equipment requirement and make LVADs of the future fully contained.

Future heart pumps are likely to be even smaller, lighter and more efficient. Advancements in battery technology, miniaturization and durability that make everyday devices around us last longer will also help tomorrow's designs, perhaps to a degree where cardiologists may recommend them over transplants.

"It could be as simple as wearing a vest that charges your heart pump like you can wirelessly charge a mobile phone," Bourque said. "We could have a situation where people don't even know you have a device inside you, and that discreetness will add a lot of appeal."

Mimicking heart rate variations

A natural heart responds to our bodies' activity and adjusts how quickly it needs to pump blood. LVADs, like the HeartMate 3, have built-in features that allow physicians to adjust pumping speeds based on patient needs. That technology will continue to become more sophisticated, allowing future mechanical pumps even more versatility.

The rise of data – and devices that measure vital signs – could help a heart pump recognize the need to pick up the pace. This can be done by measuring factors that affect heart rate today such as respiratory rates where a variable pump speed could improve the device's performance.

For example, Abbott's CardioMEMS device measures and collects data on heart performance and wirelessly transmits it to the patient's clinic. That data could be looped to a mechanical pump to ensure consistent pressure within the heart, therefore improving quality of life. Software customization and even learning algorithms could be combined to create a mechanical heart that responds much like our hearts perform today.

Helping hearts heal themselves

While improving LVAD technology could mean people picking a mechanical device first to give them decades of reliable pumping, the latest research around heart failure might afford heart pumps a new role, Bourque said; a short-term, recovery treatment.

"We need to consider how pumps can be part of a treatment strategy that ends with cardiac remission – strengthening heart performance so people re-grow healthy heart tissue and eventually don't need a pump," he said. Perhaps in the future, a pump won't be a forever-solution but a tool that combines with a broader plan to restore heart function.

"What we're focused on with our engineering are human factors around these devices – we want to have a very patient-centric and provider-centric view of how these will evolve," Bourque said. "There's a lot of promise around heart pumps and how they'll appeal to heart patients going forward."

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