Abstract
Left ventricular assist devices (LVADs) have become a viable alternative to heart transplantation in heart failure therapy. In clinical practice, rotary blood pumps used as LVADs are operated at a constant rotational speed and thus do not adapt to the varying demand of the patient. This paper presents a robust control approach for automatic adaptation of the blood pump speed to the blood flow demand of the patient’s body, which enables a defined load sharing between an LVAD and the native ventricle. Robust stability was checked using a detailed model of the human cardiovascular system with uncertainties that describe the most important native physiological control loops as well as a range of pathologies. The robust assistance controller was tested in an in vivo setup and was able to stabilize the cardiovascular system after myocardial infarction.
Zusammenfassung
Linksherzunterstützungssysteme (LVADs) haben sich in der Herzinsuffizienz-Therapie zu einer praktikablen Alternative zur Herztransplantation entwickelt. In der klinischen Praxis werden rotatorische Blutpumpen, die als LVADs eingesetzt werden, mit einer konstanten Drehzahl betrieben. Jedoch passen sich diese nicht an den sich ändernden Blutflussbedarf des Patienten an. Dieser Beitrag präsentiert einen robusten Regelungsansatz zur automatischen Anpassung der Blutpumpendrehzahl an den Bedarf des Patienten, der zusätzlich eine definierte Verteilung der hydraulischen Last zwischen dem LVAD und dem natürlichen Herzen ermöglicht. Die robuste Stabilität des Reglers wurde mit Hilfe eines detaillierten Modells des menschlichen Herz-Kreislauf-Systems mit Unsicherheiten gezeigt. Diese Unsicherheiten beschreiben die wichtigsten natürlichen physiologischen Regelkreise sowie eine Reihe von Pathologien. Die robuste Assistenzregelung wurde in vivo getestet und konnte das Herz-Kreislauf-System nach einem Myokardinfarkt stabilisieren.
Funding source: Bundesministerium für Bildung und Forschung
Award Identifier / Grant number: 13GW0118C
Funding statement: This work has been funded by the Federal Ministry of Education and Research (BMBF, Germany) and is part of the project inHeart (grant number 13GW0118C).
About the authors
Daniel Rüschen received the M. Sc. degree in Electrical Engineering, Information Technology and Computer Engineering from RWTH Aachen University, Aachen, Germany, where he is currently working towards the Dr.-Ing. degree as a Research Associate at the Philips Chair for Medical Information Technology. His main research interests include physiological and robust control of rotary blood pumps for automated ventricular assist device therapy.
Sebastian Opitz completed his Master’s thesis at the Philips Chair for Medical Information Technology in which he focused on robust control, uncertainty modeling and physiological modeling.
Philip von Platen received his M. Sc. degree in Electrical Engineering, Information Technology and Computer Engineering from the RWTH Aachen University, Aachen, Germany. He is currently working as a Research Associate at the Philips Chair for Medical Information Technology, RWTH Aachen University, whilst pursuing the Dr.-Ing. degree. His main research interests are in the field of automation of protective artificial ventilation.
Leonie Korn received the M. Sc. degree in Electrical Engineering, Information Technology and Computer Engineering from RWTH Aachen University, Aachen, Germany, where she is currently working towards the Dr.-Ing. degree as a Research Associate at the Philips Chair for Medical Information Technology. Her research focuses are sensor technology, FEM simulations, and signal processing in heart volumetry.
Steffen Leonhardt received the M. S. degree in computer engineering from the State University of New York at Buffalo, Buffalo, NY, USA, the Dr.-Ing. degree in electrical engineering from the Technical University of Darmstadt, Darmstadt, Germany, and the M. D. degree in medicine from J. W. Goethe University, Frankfurt, Germany. He was appointed Full Professor and Head of the Philips endowed Chair of Medical Information Technology at RWTH Aachen University, Aachen, Germany, in 2003. In 2014, he became a fellow of the NRW Academy of Sciences, Humanities and the Arts in Düsseldorf. In 2015, he was appointed a distinguished lecturer by the IEEE EMBS.
Marian Walter received the Dipl.-Ing. and Dr.-Ing. degrees in electrical engineering with a specialization in control engineering from the Technical University of Darmstadt, Darmstadt, Germany, in 1995 and 2002, respectively. He worked for three years in R&D at Draeger Medical, Lübeck developing Anaesthesia machines. Subsequently, he was appointed Senior Scientist and deputy head with the Philips Chair of Medical Information Technology, RWTH Aachen University, Aachen, Germany, in 2004. His current research interests include noncontact monitoring techniques, signal processing, and feedback control in medicine.
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