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

Abstract

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.

Conduction System Disorders Associated with Valvular Heart Disease and Interventions

“…TTVIs have shown improvement in RV performance and hemodynamics up to 6 months post-procedure, as well as improvement in HF rehospitalizations and survival up to 1-year post-procedure. An expected complication of TTVIs is heart block, though this has not been a widely report complication in preliminary reports [39,40]. As the TTVI experience improves, it may become an effective strategy to treat pacemaker-induced TR (Section 5.5).…”