Second pulse, second heartbeat delivers complex care for heart failure patients

A second heartbeat. It’s a simple concept that delivers complex care for heart failure patients … and all it takes is a little air.

Stacey Smith, heart failure patient: “I’m panting, I’m breathing very heavily. I had a hard time walking across the room.”

It’s been 16 years since Stacey Smith’s first heart attack. In the years that followed, the father of three grown daughters -- and grandfather of two -- had a defibrillator and pacemaker implanted … then a second heart attack and triple bypass surgery. After a third heart attack, the accumulated damage left the now 54-year-old severely weakened and with little quality of life.

Dr Valluvan Jeevanandam, University of Chicago Medicine Cardiac and Thoracic Surgeon: “When you’re in heart failure, the heart is not generating enough power into the circulation so you need to increase power.”

The most well-known device that helps boost the heart’s pumping power is an LVAD – a left ventricular assist device.

Dr Jeevanandam: “What they do is take blood out of the heart, spin them in a turbine and then eject them back into the aorta. That’s one way to generate power in the circulation. They are great devices, but they all have some complications, including bleeding, infection, stroke, thrombosis from the blood being spun so fast. The other way to energize the circulation is called counter pulsation

Stacey Smith, heart failure patient: “What you’re hearing here I feel in my chest.”

Think of it as a second pulse.

Stacey Smith: “I sound like Chitty Chitty Bang Bang. Sounds like I got a pretty crappy heart, but it’s music to my ears.”

That sound is the counter-pulsation device as it thrusts an extra burst of blood through Stacey’s body – in between his natural heart beats.

Dr Jeevanandam: “This device pumps when the heart is relaxed, and it is deflated when the heart pumps. So it is in counter pulsation to the heart, which is where you get the second pulse.”

The power comes from a simple source … air that activates what looks like a balloon resting in the patient’s aorta. As it inflates more blood is pushed out toward the patient’s organs.

Dr Jeevanandam: “We access the aorta thru a small incision in the subclavian artery and we drop the device into the descending aorta. That’s the only surgical procedure, so you don’t have to open up the chest you don’t have to open up anything.”

University of Chicago Medicine cardiac and thoracic surgeon Dr Valluvan Jeevanandam helped design the device – known as the NuPulse intravascular ventricular assist system.

Dr Jeevanandam: “If it’s not powerful enough you can always escalate to an LVAD but have this device as a ‘why not device’ why wouldn’t you put this in and see how they respond?”

Electrodes placed underneath the skin detect the patient’s heart beat then tell the system when to pump and when not to pump.

Colleen Juricek, RN, University of Chicago Medicine LVAD Coordinator: “It’s pretty simple. What the patient sees is this here. This is the patient connector, so you can actually disconnect this if we wanted to change out a drive line or fix something and then all of this is what the patient sees.”

The tubing, power and data lines connect between the patient’s abdomen and this portable black box that houses the system’s driver.

Stacey Smith: “I’m 100 times better than when I got here.”

Stacey is the fifth patient to be implanted with the assistive device as part of a clinical trial at University of Chicago Medicine. He’ll stay in the hospital and connected to the pump as he waits for a heart transplant.

Stacey Smith: “My energy levels have gone through the ceiling since this thing has come into my life.”

The ultimate goal is to have patients take the pump home. But for now it’s being tested on in-patients awaiting a transplant. There are risks associated with placing the device in the blood stream – blood clots and infection among them. And not all patients may respond as well as Stacey Smith has so far.

You can learn more about the clinical trial at: UCHospitals website of by calling 773-702-2500