Rapid pacing using the 0.035‐in. Retrograde left ventricular support wire in 208 cases of transcatheter aortic valve implantation and balloon aortic valvuloplasty

Hilling-Smith, Roland; Cockburn, James; Dooley, Maureen; Parker, Jessica; Newton, Andrea; Hill, Andrew; Trivedi, Uday; Belder, Adam de; Hildick‐Smith, David

doi:10.1002/ccd.26720

Cited by 49 publications

(28 citation statements)

References 5 publications

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“…However, in 2.6% of patients, new and permanent PM implantation was required, which did not occur in our study. In another study by Hilling-Smith et al, 76 patients undergoing BAV alone and 110 patients undergoing BAV with TAVR using only LV pacing were enrolled [14]. This study provided similar findings: consistent pacing, reduced procedural time, reduced vascular complications and a possibility of early patient mobilization.…”

Section: Discussionmentioning

confidence: 57%

“…To prevent this situation, the operator should push the guidewire towards the LV, which may increase the risk of cardiac tamponade. In our study, the final success rate of wire pacing was 100%, but in previous studies the authors reported successful pacing in 84.9%-100.0% of cases [13,14,17]. In the case of initially unsuccessful wire pacing, we scraped the distal portion of the wire where the alligator clamp should be attached with subsequently ensured pacing.…”

Section: Discussionmentioning

confidence: 65%

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Direct Rapid Left Ventricular Wire Pacing during Balloon Aortic Valvuloplasty

Kleczyński

Dziewierz

Socha

et al. 2020

JCM

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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, p = 0.02; 5.4 vs. 10.3 min, p = 0.01; 17 vs. 25 min, p = 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%, p = 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.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 65%

Direct Rapid Left Ventricular Wire Pacing during Balloon Aortic Valvuloplasty

Kleczyński

Dziewierz

Socha

et al. 2020

JCM

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“…Any positioning of a dedicated pacing electrode is time-consuming and involves additional X-ray exposure. However, several published reports describe successful and safe rapid pacing using the left ventricle guidewire during valve implantation in transcatheter aortic valve replacement (TAVR) [10,11].…”

Section: Introductionmentioning

confidence: 99%

Rapid Pacing Using the Guidewire During Transcatheter Tricuspid Valve in Valve Implantation

Kar¹,

Noureddin²,

Aboulhosn³

et al. 2017

jshd

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Transcatheter valve replacement is now widely used to treat high-risk patients. This approach is also expanding to the tricuspid valve, mostly for "valve-invalve" and "valve-in-ring" implantations. Rapid pacing during transcatheter valve implantation is used to reduce cardiac output and minimize the risk of valve dislodgement. Rapid pacing is usually done using the patient's permanent pacemaker or a temporary pacing electrode that is usually introduced retrogradely into the left ventricle or coronary sinus. Here, we describe the use of the tricuspid valve-in-valve implantation super-stiff guidewire for rapid pacing during implantation of the valve. This approach may obviate the need for ancillary steps that may increase procedure time, X-ray exposure, and risk of complications.

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“…2 RVP with rates of 140-200 bpm are also used routinely during transcatheter aortic valve replacements to decrease stroke volume and mean aortic pressure during balloon valvuloplasty of the aortic valve and deployment of the valve. 3 This is even used in patients with depressed ventricular function or nonrevascularized coronary disease, although the duration of RVP is minimized in these cases.…”

mentioning

confidence: 99%