Ex vivo evaluation of a roller screw linear muscle actuator for an implantable ventricular assist device using trained and untrained latissimus dorsi muscles.

In this study, the power output and contraction length of trained and untrained canine latissimus dorsi (LD) muscles were measured using a roller screw linear muscle actuator (RSLMA). The RSLMA consisted of a roller screw-nut assembly and translation unit to convert the linear pull force of the muscle into an axial displacement of the roller screw. When a cable wound around a spool attached at each end of the roller screw nut was pulled in either direction, the nut was rotated which in turn advanced the roller screw in the axial direction. Under anesthesia, a Telectronics myostimulator (Model 7220) was implanted in the subcutaneous area of the canine left thoracic region with its bipolar intramuscular leads implanted around the thoracodorsal nerve and the distal muscle. A total of 6 dogs went through the myostimulator implantation, followed with 8 weeks of continuous stimulation. After completion of the training, the contraction lengths of the trained and untrained LD muscles were measured, and they were 4.25 and 5.5 cm, respectively, while the instantaneous power outputs were 4.24 and 8 W, respectively. Although untrained muscles could provide much higher instantaneous power immediately following the start of the stimulation, it diminished rapidly. On the other hand, the trained muscle showed prolonged fatigue resistance. The thoracolumbar and humeral approaches in attaching the actuator cable did not show a difference with respect to muscle power output. The trained LD muscle can provide sufficient power in the range of 3-4 W to drive a left heart assist device, but its long-term evaluation awaits development of an appropriate muscle-device interface for chronic in vivo application.