Surreal image of a heart emitting rhythmic waves, symbolizing oscillatory ventilation.

Decoding Exertional Oscillatory Ventilation: What It Means for LVAD Patients

Lena Kashyap in Health & Wellness July 2025 • 3 min read.

"Understand the prevalence, causes, and implications of exertional oscillatory ventilation in individuals with left ventricular assist devices."

When dealing with heart failure, understanding the warning signs is crucial. One such sign is exertional oscillatory ventilation (EOV). This unusual breathing pattern can show up during exercise in people with reduced left ventricular ejection fraction—a key measure of how well the heart pumps blood.

But what about individuals with left ventricular assist devices (LVADs)? These devices help the heart pump, but the role and frequency of EOV in these patients haven’t been clear. A recent study sheds light on this important question.

This article breaks down the research, explaining what EOV is, how it's detected, and what it might mean for those living with LVADs. We'll explore the study's findings, potential causes, and what this could mean for improving patient care.

What is Exertional Oscillatory Ventilation (EOV)?

Surreal image of a heart emitting rhythmic waves, symbolizing oscillatory ventilation.

EOV is a specific type of breathing pattern. Instead of steady breaths, ventilation waxes and wanes rhythmically during exercise. Imagine your breath increasing, then decreasing, then increasing again in a cyclical pattern. This isn’t just being out of breath; it’s a sign of underlying cardiovascular and respiratory issues.

For people with heart failure and reduced ejection fraction (HFrEF), EOV is a red flag. Studies have shown it significantly increases the risk of adverse events. This is why understanding its presence and causes is crucial for better patient management.

EOV indicates potential instability in the cardiovascular and respiratory systems.
It’s observed during cardiopulmonary exercise testing (CPET).
EOV serves as a marker for increased risk in heart failure patients.

Researchers used cardiopulmonary exercise testing (CPET) and Kremser's criteria to define EOV. CPET involves monitoring a patient's breathing, heart rate, and other vital signs while they exercise on a stationary bike or treadmill. This test helps doctors understand how well the heart and lungs function under stress. Kremser’s criteria provide a standardized way to identify EOV based on the oscillatory pattern of ventilation during CPET.

The Bigger Picture: Implications and Future Directions

This study confirms that exertional oscillatory ventilation is a relevant concern for LVAD recipients, similar to those with heart failure due to reduced ejection fraction. Recognizing EOV can prompt further investigation into underlying issues, such as hemodynamic and ventilatory dysfunction. Further research is needed to fully understand the mechanisms behind EOV in LVAD patients and how it impacts long-term outcomes. Additionally, interventions aimed at reducing EOV and improving exercise capacity in this population should be explored.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1177/2047487318801415, Alternate LINK

Title: Prevalence Of Exertional Oscillatory Ventilation In Continuous-Flow Left Ventricular Assist Device Recipients

Subject: Cardiology and Cardiovascular Medicine

Journal: European Journal of Preventive Cardiology

Publisher: Oxford University Press (OUP)

Authors: Massimo Pistono, Marco Gnemmi, Alessandro Imparato, Klara Komici, Ugo Corrà

Published: 2018-09-24

Everything You Need To Know

What exactly is Exertional Oscillatory Ventilation (EOV) and how is it identified during testing?

Exertional Oscillatory Ventilation (EOV) is characterized by a rhythmic waxing and waning of ventilation during exercise, where breathing increases and decreases cyclically. It's detected using cardiopulmonary exercise testing (CPET) and defined by Kremser's criteria, which standardizes the identification of EOV based on ventilation patterns during CPET. EOV is not just being out of breath; it's indicative of underlying cardiovascular and respiratory issues.

How are cardiopulmonary exercise testing (CPET) and Kremser’s criteria used in the diagnosis of Exertional Oscillatory Ventilation (EOV)?

Cardiopulmonary exercise testing (CPET) involves monitoring a patient's breathing, heart rate, and other vital signs while they exercise, usually on a stationary bike or treadmill. This helps doctors evaluate heart and lung function under stress. Kremser’s criteria provide a standardized method to identify Exertional Oscillatory Ventilation (EOV) from the oscillatory ventilation pattern observed during CPET. Together, CPET and Kremser’s criteria offer a structured approach to diagnosing EOV.

What does it mean if someone with heart failure and reduced ejection fraction (HFrEF) is showing signs of Exertional Oscillatory Ventilation (EOV)?

For individuals with heart failure and reduced ejection fraction (HFrEF), the presence of Exertional Oscillatory Ventilation (EOV) is a concerning indicator. Research has shown that EOV is associated with a significantly increased risk of adverse events in this population. Recognizing EOV in patients can lead to further investigation into potential hemodynamic and ventilatory dysfunction.

What are the key implications of the recent findings regarding Exertional Oscillatory Ventilation (EOV) in patients with left ventricular assist devices (LVADs)?

The study suggests that Exertional Oscillatory Ventilation (EOV) is a relevant consideration for individuals with left ventricular assist devices (LVADs), similar to those with heart failure due to reduced ejection fraction. Recognizing EOV in LVAD recipients can prompt further investigation into potential underlying issues, such as hemodynamic and ventilatory dysfunction. This insight is important because it highlights that even with mechanical support, breathing patterns can reveal critical information about a patient's condition.

What are the next steps in researching Exertional Oscillatory Ventilation (EOV) and what interventions might improve outcomes for LVAD patients?

Further research is needed to fully understand the underlying mechanisms behind Exertional Oscillatory Ventilation (EOV) in left ventricular assist device (LVAD) patients and how it impacts their long-term outcomes. Future studies should focus on interventions aimed at reducing EOV and improving exercise capacity in this patient population. Understanding the mechanisms and developing targeted interventions could significantly improve the quality of life and overall outcomes for LVAD recipients experiencing EOV.