Ventricular Assist Device Patients with Adjustable Cardiac Excitation - Hemodynamic Study (V PACE - H)

Bi-ventricular (BiV) pacing has been shown to be beneficial to patients with end-stage cardiomyopathy. Whether those benefits persist following left ventricular assist device (VAD) implantation remains unclear and consequently continuance of BiV-pacing post-VAD implantation is highly variable even within our own institution. It is standard of care to adjust pacing modes and perform surveillance echocardiograms and right heart catheterizations in this population providing a unique opportunity to tailor therapy to the individual patient. The primary aim of this proposal is to assess the hemodynamic effects of different ventricular pacing modes. To do this we will examine VAD patients with echocardiography and right heart catheterization during bi-ventricular, uni-ventricular and non-pacing (native conduction). The goal of this study will be to determine the most efficient way to pace patients with a ventricular assist device. This study is unique in that it aims to perform the assessment (echocardiogram/right heart catheterization) and intervention (pacing mode adjustment) simultaneously to maximize the information obtained and conceivably benefit reaped for each patient.