{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T12:25:21Z","timestamp":1778243121760,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T00:00:00Z","timestamp":1422316800000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Xenios AG, Germany","award":["157898"],"award-info":[{"award-number":["157898"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Arrhythmias are a frequent complication during extracorporeal life support (<jats:styled-content style=\"fixed-case\">ECLS<\/jats:styled-content>). A new <jats:styled-content style=\"fixed-case\">ECLS<\/jats:styled-content> system can provide pulsatile flow synchronized to the patient's intrinsic cardiac cycle based upon the R wave of the electrocardiogram (<jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content>). It is unclear how the occurrence of arrhythmias may alter the hemodynamic performance of the system. This in vitro study evaluated the effect of simulated arrhythmias on hemodynamics during R wave\u2010triggered pulsatile <jats:styled-content style=\"fixed-case\">ECLS<\/jats:styled-content>. The <jats:styled-content style=\"fixed-case\">ECLS<\/jats:styled-content> circuit with an i\u2010cor diagonal pump and <jats:styled-content style=\"fixed-case\">iLA<\/jats:styled-content> membrane ventilator was primed with whole blood at room temperature. Flow and pressure data were collected at 2.5 and 4\u2009L\/min for each condition using a customized data acquisition system. Pulsatile <jats:styled-content style=\"fixed-case\">ECLS<\/jats:styled-content> flow was <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content> wave synchronized to an <jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content> simulator using 1:1, 1:2, and 1:3 assist ratios. Conditions tested included sinus rhythm at 45 and 90\u2009bpm, supraventricular tachycardia (<jats:styled-content style=\"fixed-case\">SVT<\/jats:styled-content>), ventricular tachycardia (<jats:styled-content style=\"fixed-case\">VT<\/jats:styled-content>), and irregular rhythms such as ventricular fibrillation. Pulsatile mode was successfully triggered by <jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content> signals of normal sinus rhythm, SVT, VT, atrial fibrillation, atrial flutter, and ventricular bigeminy with assist ratios 1:1, 1:2, and 1:3. Regular rhythm at 90\u2009bpm generated the best surplus hemodynamic energy (<jats:styled-content style=\"fixed-case\">SHE<\/jats:styled-content>). For <jats:styled-content style=\"fixed-case\">SVT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">VT<\/jats:styled-content>, an assist ratio of 1:2 resulted in maximum pulsatile flow waveforms with optimal <jats:styled-content style=\"fixed-case\">SHE<\/jats:styled-content> at 2.5\u2009L\/min flow rate. At 4\u2009L\/min, <jats:styled-content style=\"fixed-case\">SHE<\/jats:styled-content> declined and the pressure drop increased independent of arrhythmia condition. Irregular rhythms still produced adequate pulsatile wave forms at lower pulsatile frequency. This study demonstrated the feasibility of generating pulsatile <jats:styled-content style=\"fixed-case\">ECLS<\/jats:styled-content> flow with the novel <jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content>\u2010synchronized i\u2010cor system during various simulated rhythms. The optimal rate for pulsatile flow was 90\u2009bpm. During irregular rhythms, the lower pulsatile frequency was the more reliable synchronization mode for generating pulsatile flow.<\/jats:p>","DOI":"10.1111\/aor.12454","type":"journal-article","created":{"date-parts":[[2015,1,28]],"date-time":"2015-01-28T03:22:31Z","timestamp":1422415351000},"page":"67-76","source":"Crossref","is-referenced-by-count":29,"title":["Evaluation of a Novel Pulsatile Extracorporeal Life Support System Synchronized to the Cardiac Cycle: Effect of Rhythm Changes on Hemodynamic Performance"],"prefix":"10.1111","volume":"39","author":[{"given":"Sunil","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Pediatrics Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Pauliks","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph B.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"},{"name":"Department of Surgery Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allen R.","family":"Kunselman","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sciences Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akif","family":"\u00dcndar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"},{"name":"Department of Surgery Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA USA"},{"name":"Department of Bioengineering Penn State Hershey Pediatric Cardiovascular Research Center Penn State Hershey College of Medicine  Hershey PA 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