Direct rapid left ventricular wire pacing during balloon aortic valvuloplasty
| Autor: | Saleh Arif, Sylwia Socha, Joanna Wojtasik-Bakalarz, Marzena Daniec, Paweł Kleczyński, Artur Dziewierz, Dariusz Dudek, Barbara Zawislak, Tomasz Rakowski, Lukasz Rzeszutko |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment wire lcsh:Medicine aortic valve stenosis 030204 cardiovascular system & hematology Balloon Article 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Fluoroscopy 030212 general & internal medicine pacing medicine.diagnostic_test business.industry lcsh:R General Medicine medicine.disease Aortic valvuloplasty Temporary Pacemaker Stenosis medicine.anatomical_structure balloon aortic valvuloplasty Ventricle Aortic valve stenosis Cardiology cardiovascular system business Complication |
| Zdroj: | Journal of Clinical Medicine Volume 9 Issue 4 Journal of Clinical Medicine, Vol 9, Iss 1017, p 1017 (2020) |
| Popis: | 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&Prime 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. |
| Databáze: | OpenAIRE |
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