wave will occur for rhythmic beats and for some rhythms displaying transient disturbances such as premature ventricular complexes pvcs in the presence of rhythmic beats the u201c automated u201d balloon pump is typically programmed and adjusted to initiate deflation of the balloon prior to the next r wave so as to allow for complete or near complete balloon deflation prior to the start of systole in the presence of random and chronically irregular rhythms such as atrial fibrillation however prediction of the next r wave is not possible in such situations the balloon pumps are generally operated to deflate the balloon on the detected leading edge of the r wave r wave deflation as illustrated in fig1 r wave deflation results in the heart ejecting blood into a blood vessel containing an only partially deflated balloon the advantage to r wave deflation however is that deflation begins upon the identification of the next r wave regardless of the variance of the rhythm permitting the pump to consistently augment the entire diastolic interval and unload the impending left ventricular contraction reverting to r wave deflation in the presence of random and chronically irregular rhythms is often preferred reverting to r wave deflation in the presence of regular or only transient rhythm disturbances specifically those recognizable by the balloon pump however is unnecessary the present invention comprises a balloon pump which bases its decision of alternating between a predictive deflation mode and r wave deflation mode or.