Home Monitoring Reduces Gastrointestinal Bleeding Events for LVAD

A LVAD, or left ventricular assist device, is a pump that is surgically implanted into the chest to assist a weakened heart in pumping oxygen-rich blood to the body.1 These devices are primarily used to treat advanced stages of heart failure. This disease affects over five million people in the United States.2 

LVAD implantation is a big adjustment for you and your family, both physically and emotionally. However, thousands of patients worldwide are living productive lives with their LVAD. Most patients return to living at home, moving about freely, enjoying favorite activities, exercising, returning to work or school and driving.4,5  

One potential complication of LVAD implants is blood clotting inside the pump. You will be prescribed the medication warfarin or another anticoagulant, to prevent blood clots from forming in the mechanical pump device. Warfarin requires monitoring of blood levels through a blood test called INR (International Normalized Ratio). This blood test lets your doctor know if your medication needs to be adjusted. There are several different ways to test the blood for INR levels: at the lab, in the doctor’s office or at home. 

When you are discharged after your LVAD surgery, home monitoring allows you to monitor your INR from the comfort of your home. This is done through the use of a device that requires a fingerstick drop of blood and provides results within 60 to 90 seconds. Testing can be done on a frequent basis so that your doctor can adjust your medication levels to prevent clot complications. 

In a 2016 study conducted by the University of California San Francisco (UCSF), frequent home INR monitoring, reduced the risk of bleeding in the stomach or intestines (gastrointestinal bleeding). After LVAD surgery, you are at higher risk for this type of bleeding. In the UCSF study, participants used a home INR meter and the Alere VADWatch® program to report results. The study found a 19.7% reduction in the risk of gastrointestinal bleeding, as well as a trend towards fewer clotting events, as compared to usual care (testing INR every one to three weeks by the lab).3 

Always consult your physician if you have questions about LVAD or home monitoring. 

Resources:

  1. www.merriam-webster.com/medical/vad
  2. National Heart, Lung and Blood Institute. How is Heart Failure Treated? www.nhlbi.gov. June 22, 2015. Retrieved from the website: http://www.nhlbi.nih.gov/health/health-topics/topics/hf/treatment
  3. Home Monitoring is Associated with Fewer Gastrointestinal Bleeding Events Following Left Ventricular Assist Device Implantation, Psotka, et al, UCSF
  4. Mayo Foundation for Medical Education and Research. Left Ventricular Assist Device (LVAD). Mayo Clinic. 2017. Retrieved from the website: http://www.mayoclinic.org/tests-procedures/ventricular-assist-devices/multimedia/left-ventricular-assist-device-lvad/img-20006714.
  5. National Heart, Lung and Blood Institute. Ventricular Assist Device. www.nhlbi.gov. December 9, 2016. Retrieved from the website: http://www.nhlbi.nih.gov/health/health-topics/topics/vad/.