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Revision of current evidence suggests that high technology pump speed algorithms, a \u2018hypothesis of decreasing pump's speed\u2019 to promote pulsatile flow and a \u2018hypothesis of increasing pump's speed\u2019 to increase peakVO<jats:sub>2<\/jats:sub>, may only partially reverse these barriers. A \u2018hypothesis of increasing patient's speed\u2019 is introduced, suggesting that exercise training may further contribute to the patient's recovery, enhancing peakVO<jats:sub>2<\/jats:sub> and pulsatile flow by improving skeletal muscle oxidative capacity and strength, peripheral vasodilatory and ventilatory responses, favour changes in preload\/afterload and facilitate native flow, formulating the rationale for further studies in the field. <\/jats:p>","DOI":"10.1177\/2047487319856448","type":"journal-article","created":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T16:51:42Z","timestamp":1560185502000},"page":"1806-1815","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Restoring pulsatility and peakVO<sub>2<\/sub> in the era of continuous flow, fixed pump speed, left ventricular assist devices: \u2018A hypothesis of pump's or patient's 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