Successful transesophageal pacing in a very-low-birth-weight-infant with atrioventricular block

Nomura, Ryunosuke; Shiraga, Kazuhiro; Inuzuka, Ryo

doi:10.1017/s1047951122001706

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Its dimensions are safely compatible with patients weighing at least 2.5 kg 12 . In smaller infants, it may be potentially used 13 by introducing it from the oral cavity, to avoid nasal trauma. Transesophageal pacing rarely injures the esophageal mucosa 14 and it is contraindicated in patients with known esophageal lesions or malformations (e.g., esophageal atresia).…”

Section: Discussionmentioning

confidence: 99%

Rapid transesophageal atrial pacing for balloon aortic valvuloplasty in neonates and infants: A new technique for balloon stabilization

Meliota,

Lombardi,

Vairo

2023

Cathet Cardio Intervent

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Balloon aortic valvuloplasty (BAV) is preferred by most centers over surgery for the treatment of congenital valve stenosis, due to its less invasive nature and faster recovery time. A variety of techniques have been employed to induce a transient cardiac standstill and reduce longitudinal balloon displacement during valve dilatation. Rapid right ventricular (RV) pacing is an effective method to stabilize the balloon during aortic valvuloplasty and it is regularly used in older children and adults. Despite the evidence of its feasibility and efficacy, its use in neonates and infants is still not widespread globally as it is associated with certain drawbacks in this population. We report the use of a new technique to achieve balloon stabilization during BAV in neonates and infants. Four patients with severe congenital aortic valve stenosis were treated with percutaneous BAV using rapid transesophageal atrial pacing. Rapid atrial pacing was performed in asynchronous modality at a rate which resulted in a drop of the systemic arterial pressure by 50%. The balloon was inflated only after the set pacing rate was reached. The pacing was continued until the balloon was completely deflated. No ventricular arrhythmia occurred. Fluoroscopy time was not influenced by transesophageal pacing. Mild aortic regurgitation developed in only one case. Rapid transesophageal atrial pacing was safe and allowed a significant relief of left ventricular obstruction while minimizing aortic regurgitation. Compared to RV pacing, it does not require additional vascular access. Moreover, transesophageal pacing is not at risk of cardiac or vascular perforation and ventricular arrhythmias.

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Section: Discussionmentioning

confidence: 99%