Direct Rapid Left Ventricular Wire Pacing during Balloon Aortic Valvuloplasty

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 pacemake...

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Veröffentlicht in:Journal of clinical medicine 2020-04, Vol.9 (4), p.1017
Hauptverfasser: Kleczynski, Pawel, Dziewierz, Artur, Socha, Sylwia, Rakowski, Tomasz, Daniec, Marzena, Zawislak, Barbara, Arif, Saleh, Wojtasik-Bakalarz, Joanna, Dudek, Dariusz, Rzeszutko, Lukasz
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Sprache:eng
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Zusammenfassung: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. 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. 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). 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.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm9041017