Real-Time Analysis of the Log Files of the HeartWare Continuous-Flow Left Ventricular Assist Device for the Early Diagnosis of Pump Thrombosis: a Step Forward Toward Clinical Translation

We evaluated the real-time diagnostic capability of a new tool enhancing early diagnosis of pump thrombosis (PT) of the HeartWare left ventricular assist device via time-frequency analysis (TFA) of the log files. We analyzed 173 log files, including 24 (14%) associated with a clinical diagnosis of PT and 149 (86%) controls. The 30-day log file records were discretized into consecutive windows of a 24-h duration, which were iteratively acquired and processed via TFA. This way, we simulated longitudinal acquisition of pump parameters and provided real-time analysis of consecutive data, thus resembling the clinical scenario. Sensitivity and specificity of the tool were 79% and 84%, respectively. Sensitivity against PT events with progressive "build-up" thrombus increased up to 95%, and early signs of a forthcoming PT were identified 10 +/- 8 days prior to its clinical manifestation. This study demonstrates high reliability and the potential for effective clinical translation of this prognostic tool.