Synchronized cardiac support –
pulsatile VA ECMO

Synchronized cardiac support (SCS) is an ECG-triggered pulsatile venoarterial extracorporeal membrane oxygenation (VA ECMO).

The technical principle of SCS is the synchronization of the pump speed and therefore the extracorporeal blood flow (EBF) with the cardiac cycle based on R-wave detection. During the diastole, the pump speed is increased by 3500 rounds per minute (rpm) compared to the pump speed during the systole.

Hypothetically, an increased diastolic blood flow may enhance coronary perfusion while a decreased systolic blood flow may reduce left ventricular afterload compared to continuous flow VA ECMO.[1] Preclinical studies[2-7] already observed this benefit. Clinical studies to generate evidence for SCS treatment are scheduled.

Please note: SCS is cleared and available to a limited extent. For further information on country-specific regulations, please contact your local Xenios AG representative.

What’s the difference between pulsatile and continuous flow?

The model in the video illustrates the potential difference between continuous and pulsatile flow. The water used in the model is driven by a pump and simulates the blood flow.

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Synchronized Cardiac Support: What’s the difference between pulsatile and continuous flow?

References:

[1] Voigt, I. et al. (2021). Efficacy and safety of ECG-synchronized pulsatile extracorporeal membrane oxygenation in the clinical setting: The SynCor Trial. Artif Organs, 46(3), 387-397

[2] Ostadal, P. et al. (2018). Electrocardiogram-synchronized pulsatile extracorporeal life support preserves left ventricular function and coronary flow in a porcine model of cardiogenic shock. PLoS One, 13(4), e0196321

[3] Cremers, B. et al. (2015). Pulsatile venoarterial perfusion using a novel synchronized cardiac assist device augments coronary artery blood flow during ventricular fibrillation. Artif Organs, 39(1), 77-82

[4] Wang, S. et al. (2018). Impact of Different Perfusion Modalities on Coronary and Carotid Blood Flow Velocities in an Adult ECLS Swine Model . Artif Organs, 42(9), 918-921

[5] Wang, S. et al. (2015). In Vivo Hemodynamic Performance Evaluation of Novel Electrocardiogram-Synchronized Pulsatile and Nonpulsatile Extracorporeal Life Support Systems in an Adult Swine Model. Artif Organs, 39(7), E90-E101

[6] Zhang, Y. et al. (2021). Pulsatility protects the endothelial glycocalyx during extracorporeal membrane oxygenation. Microcirculation, 28(7), e12722

[7] Li, G. et al. (2021). The Pulsatile Modification Improves Hemodynamics and Attenuates Inflammatory Responses in Extracorporeal Membrane Oxygenation. J Inflamm Res, 14, 1357-1364