Next generation mobile circulatory support

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Abstract

Heart failure is an abnormality of the cardiac function and structure, with a progressive weakening of the heart muscle. In the late stages of congestive heart failure where medication and life style changes do not work anymore, specialized interventions like heart transplantation or mechanical circulatory support becomes necessary.

A left ventricular assist device (LVAD) is an electromechanical device for assisting cardiac circulation and is used either to partially or to completely replace the function of a failing left ventricle. It consists of a surgically implanted pump; and externally worn control unit and battery pack. Today, it is mainly used as a bridge to transplantation, until a donor heart becomes available; as a bridge to recovery, until the patient recovers from a heart attack or inflammation; bridge to candidacy, until the other dieses like kidney failure is treated; and as a destination therapy to provide a life-time support for transplantation ineligible patients. Today mobile circulatory support devices give possibility to those patients to be outside of hospitals and continue their lives. However, this might limit mobility, create emotional distress and bring life-style changes to adapt.

Inspiration and Method

The aim of this project to explore this topic using the methods of user centered design and to address patients’ needs on a both functional and psychological level. The research is done with the help of Umeå University Hospital(Sweden), Örnsköldsvik Hospital(Sweden) and Ege University Hospital(Turkey). By interviewing with the patients, as well as other key stakeholders like LVAD nurses, caregivers and physicians, the main insights were created. Besides functional issues around the topic such as physical ergonomics and cognitive ergonomics, exploring the emotional side of the patients’ connections to these devices and their emotional needs were also key in this process.

By low-fidelity prototyping and exploring the concepts further with a time-based media, sacrificial concepts was created and evaluated with the patients, caregivers and LVAD nurses, leading to final concept ENO.

Result

ENO offers users more freedom by providing an adaptable solution for different contexts and scenarios. It aims to encourage the patients to a more active life style and communicate the feeling of safety and security with its semantics. Long duration batteries following the body shape can be worn discreetly under the clothing for day-time use scenarios. Patients can have greater extend of freedom using the small battery pack at home or when they are physically active. With the smart patch staying on the body in the internal battery mode, patients get feedback about internal implant status, and can be free of externally worn batteries for shorter durations while showering and intimacy scenarios. Utilizing the Transcutaneous Energy Transfer system (TET), wireless power transfer through skin, it eliminates the risk of infection related to percutaneous driveline and improves patient experience.

With the help of distant monitoring and digital platform connecting the key stakeholders, it enables both caregivers and LVAD nurses to stay notified in case of emergency alarms, simplifies the daily self-monitoring for patients, and creates more insightful data for healthcare providers.