Physiologic Data-Driven Iterative Learning Control for Left Ventricular Assist Devices
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Date
2022-07
Publication Type
Journal Article
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Abstract
Continuous flow ventricular assist devices (cfVADs) constitute a viable and increasingly
used therapy for end-stage heart failure patients. However, they are still operating at a
fixed-speed mode that precludes physiological cfVAD response and it is often related to
adverse events of cfVAD therapy. To ameliorate this, various physiological controllers have
been proposed, however, the majority of these controllers do not account for the lack of
pulsatility in the cfVAD operation, which is supposed to be beneficial for the physiological
function of the cardiovascular system. In this study, we present a physiological data-
driven iterative learning controller (PDD-ILC) that accurately tracks predefined pump flow
trajectories, aiming to achieve physiological, pulsatile, and treatment-driven response
of cfVADs. The controller has been extensively tested in an in-silico environment
under various physiological conditions, and compared with a physiologic pump flow
proportional-integral-derivative controller (PF-PIDC) developed in this study as well
as the constant speed (CS) control that is the current state of the art in clinical
practice. Additionally, two treatment objectives were investigated to achieve pulsatility
maximization and left ventricular stroke work (LVSW) minimization by implementing
copulsation and counterpulsation pump modes, respectively. Under all experimental
conditions, the PDD-ILC as well as the PF-PIDC demonstrated highly accurate tracking
of the reference pump flow trajectories, outperforming existing model-based iterative
learning control approaches. Additionally, the developed controllers achieved the
predefined treatment objectives and resulted in improved hemodynamics and preload
sensitivities compared to the CS support.
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published
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Journal / series
Volume
9
Pages / Article No.
922387
Publisher
Frontiers Media
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Date collected
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Subject
LVAD; Heart failure; Data driven control; Iterative learning control; VAD physiological control; Ventricular assist device; ILC; Pulsatile blood pumps
Organisational unit
03943 - Meboldt, Mirko / Meboldt, Mirko