To identify myocardial recovery, a standardized screening protocol should be used [393]. Accordingly, patients should undergo routine echocardiographic screening during outpatient visits at regular intervals. Specifically, ventricular function, shape and dimensions should be assessed in a quantitative manner [393]. In the setting of sinus rhythm and complete ventricular remodelling (left ventricular end-diastolic diameter ≤55 mm; left ventricular ejection fraction ≥45%), patients should be evaluated with echocardiography at reduced pump speed for weaning eligibility. If the findings are favourable and sustained, the patients may progress to invasive testing [393], which may include right heart catheterization with the pump speed reduced to the lowest possible level for 15 min. Some centres have stopped using the LVAD and balloon-occluded the outflow graft [406, 407]. Thresholds for device explantation are cardiac index >2.6 l/min/m2, pulmonary artery wedge pressure (mean) <16 mmHg, right atrial pressure (mean) <10 mmHg [393, 406]. Adequate anticoagulation must be ensured.