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Feasibility of Heart Sound Analysis in Individuals Supported with Left Ventricular Assist Devices

Left ventricular assist devices (LVADs) are surgically implanted mechanical pumps that improve survival rates for individuals with advanced heart failure. While life-saving, LVAD therapy is also associated with high morbidity, which can be partially attributed to the difficulties in identifying an LVAD complication before an adverse event occurs. Methods that are currently used to monitor for complications in LVAD-supported individuals require frequent clinical assessments at specialized LVAD centers. Remote analysis of digitally recorded precordial sounds has the potential to provide an inexpensive point-of-care diagnostic tool to assess both device function and the degree of cardiac support in LVAD recipients, facilitating real-time, remote monitoring for early detection of complications. To our knowledge, prior studies of precordial sounds in LVAD-supported individuals have analyzed LVAD noise rather than intrinsic heart sounds, due to a focus on detecting pump complications, and perhaps the obscuring of heart sounds by LVAD noise. In this letter, we describe an adaptive filtering method to remove sounds generated by the LVAD, making it possible to automatically isolate and analyze underlying heart sounds. We present preliminary results describing acoustic signatures of heart sounds extracted from in vivo data obtained from LVAD-supported individuals. These findings are significant as they provide proof-of-concept evidence for further exploration of heart sound analysis in LVAD-supported individuals to identify cardiac abnormalities and changes in LVAD support.