• Ajmal Gardiwal, Philipp Roentgen, Ulrich Luesebrink, Thorben Koenig, Gunnar Klein, and Hanno Oswald.
• Department of Cardiovascular Medicine, Hannover Medical School, Hannover, Germany. gardiwal@gmail.com
• Int J Artif Organs. 2010 Dec 1; 33 (12): 851-5.

BackgroundLeft ventricular assist devices (LVAD) are an effective therapeutic option for end-stage heart failure (HF). Reduced heart rate variability (HRV) as a result of autonomic derangement is evident in chronic heart failure and several studies have established the independent prognostic value of HRV in chronic heart failure.ObjectiveIn the present study we investigated whether autonomic function is restored in patients after LVAD implantation with persistent, severely depressed left ventricular function.MethodsAmbulatory Holter ECG recordings were collected in heart failure patients with an LVAD (n=8) und age-matched heart failure patients without an LVAD (n=7) both on optimal medical therapy. Cardiac dimensions and function were assessed by echocardiography or angiography.ResultsAnalysis for heart rate variability revealed reduced SDNN (67±4 ms), SDANN (56±4 ms) and triangular index (18±1) in heart failure patients on optimal medical therapy. However patients with LVAD demonstrated a restoration in heart rate variability with normal SDNN (108±9 ms), SDANN (103±8 ms) and triangular index (29±2). Compared to patients without LVAD this difference was statistically significant (p<0.01).ConclusionsIn end-stage heart failure patients autonomic imbalance indicated by severely reduced heart rate variability is restored after LVAD implantation with unloading of the failing heart.

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