Direct Rapid Left Ventricular Wire Pacing During Balloon Aortic Valvuloplasty

Overview

Journal J Clin Med

Specialty General Medicine

Date 2020 Apr 9

PMID 32260289

Citations 9

Authors

Pawel Kleczynski

Artur Dziewierz

Sylwia Socha

Tomasz Rakowski

Marzena Daniec

Barbara Zawislak

Saleh Arif

Joanna Wojtasik-Bakalarz

Dariusz Dudek

Lukasz Rzeszutko

Affiliations

Soon will be listed here.

Abstract

Background: Rapid ventricular pacing is mandatory for optimal balloon positioning during aortic valvuloplasty (BAV) in patients with severe aortic stenosis. We aimed to assess the safety and efficacy of direct left ventricular (LV) guidewire pacing in comparison with regular pacing induced by temporary pacemaker (PM) placement in the right ventricle.

Methods: Direct rapid LV pacing was provided with a 0.035″ guidewire. Baseline clinical characteristics, echocardiographic and procedural data, as well as complication rates, were compared between the two groups.

Results: A total of 202 patients undergoing BAV were enrolled (49.5% with direct LV guidewire pacing). The pacing success rate was 100%. In the direct LV guidewire pacing group, we found a lower radiation dose, shorter fluoroscopy and overall procedural time (0.16 vs. 0.28 Gy, = 0.02; 5.4 vs. 10.3 min, = 0.01; 17 vs. 25 min, = 0.01; respectively). In addition, the complication rate was lower in that group (cardiac tamponades, vascular access site complications, blood transfusions rate, and in-hospital mortality: 0% vs. 3.9%; 4.0% vs. 15.7%; 2.0% vs. 12.7%; 2.0% vs. 9.8%, = 0.01 for all, respectively).

Conclusions: Direct rapid LV guidewire pacing is a simple, safe and effective option for BAV with a reduced complication rate compared to a temporary PM placed in the right ventricle.

Citing Articles

Balloon Aortic Valvuloplasty in the Modern Era: A Review of Outcomes, Indications, and Technical Advances.

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Predictors, clinical impact, and management strategies for conduction abnormalities after transcatheter aortic valve replacement: an updated review.

Yu Q, Fu Q, Xia Y, Wu Y Front Cardiovasc Med. 2024; 11:1370244.

PMID: 38650916 PMC: 11033487. DOI: 10.3389/fcvm.2024.1370244.

Best Practices in Left Ventricular Pacing for Transcatheter Aortic Valve Replacement.

Blusztein D, Raney A, Walsh J, Nazif T, Woods C, Daniels D Struct Heart. 2023; 7(6):100213.

PMID: 38046859 PMC: 10692352. DOI: 10.1016/j.shj.2023.100213.

Direct wire pacing during measurement of fractional flow reserve: A randomized proof-of-concept noninferiority crossover trial.

Faurie B, Acheampong A, Abdellaoui M, Dessus I, Monsegu J, Wintzer-Wehekind J Front Cardiovasc Med. 2023; 10:1137309.

PMID: 37937287 PMC: 10625906. DOI: 10.3389/fcvm.2023.1137309.

Thoracic endovascular aortic repair of an anastomosis pseudoaneurysm after the Bentall procedure assisted by rapid ventricular pacing: A case report.

Lin J, Zhang H, Shang T, Jin B, Yao Y Heliyon. 2023; 9(6):e16833.

PMID: 37303570 PMC: 10250794. DOI: 10.1016/j.heliyon.2023.e16833.

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