Efficacy and safety of ECG-synchronized pulsatile extracorporeal membrane oxygenation in the clinical setting: The SynCor Trial

Ingo Voigt, Tobias Spangenberg, Tareq Ibrahim, Christian Bradaric, Achim Viertel, Ezequiel Marcelo Tallone, Carsten Skurk, Peter Abel, Jochen Graf, Torsten Rinne, Jürgen Böhm, Alexander Ghanem, Christoph Liebetrau

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Introduction: Mechanical circulatory support (MCS) devices are increasingly used as a treatment option in resuscitation or in patients with cardiogenic shock (CS). Prophylactic implantation in high-risk percutaneous coronary interventions (HRPCI) is another upcoming indication. The i-cor ECG-synchronized cardiac assist device combines the hemodynamic support of a veno-arterial extracorporeal membrane oxygenation (VA-ECMO) with the ability to generate a pulsatile flow and thus decreasing adverse effects of VA-ECMO on myocardial function. Aim of this study was to obtain data concerning feasibility, safety and outcomes in both indications. Methods: A total of 47 patients (34 HRPCI, 13 CS) were included in nine German centers and participated in this study. Demographic and clinical parameters, procedural as well as follow-up data were prospectively recorded and analyzed. Results: Device implantation and initiation of ECG-synchronized cardiac assist was technical successful in all cases and no failures of the consoles or disposable parts were observed. Furthermore, intended percutaneous coronary interventions and successful weaning from cardiac assist was achieved in 97.1% of HRPCI patients. We observed a 30d-survival of 94.1% in the HRPCI group and 69.2% in the CS group. Main complications in both groups were bleeding events (14.7% HRPCI, 23.1% CS) and critical limb ischemia (2.9% HRPCI, 38.5% CS). Conclusion: The i-cor ECG-synchronized cardiac assist device appears safe and feasible showing clinical outcomes comparable to existing data in the setting of high-risk percutaneous coronary interventions and acute cardiogenic shock. Further prospective trials are warranted to identify optimal patient and interventional characteristics that will benefit most of this novel kind of mechanical circulatory support.

Original languageEnglish
Pages (from-to)387-397
Number of pages11
JournalArtificial Organs
Volume46
Issue number3
DOIs
StatePublished - Mar 2022
Externally publishedYes

Keywords

  • ECG
  • cardiogenic shock
  • high-risk percutaneous coronary interventions
  • mechanical circulatory support
  • pulsatility

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