Direct left ventricular wire pacing during transcatheter aortic valve implantation
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Key result
Direct left ventricular wire pacing during transcatheter aortic valve implantation achieved a 97.6% efficacy rate and was associated with a shorter median procedure time compared to right ventricular lead pacing.
Why the study?
Although RV lead pacing has been the gold standard during TAVI, direct LV wire pacing has recently been considered safe and effective, warranting an analysis of its procedural outcomes compared with RV stimulation in unselected patients.
Does direct left ventricular wire pacing improve procedural outcomes and safety compared to right ventricular lead pacing in patients undergoing transfemoral TAVI?
Population
143 patients undergoing transfemoral TAVI
Comparison
Direct LV wire pacing vs RV stimulation
Design
Observational study
Authors
Discussion
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Implication
Direct LV wire pacing appears feasible; hypothesis-generating for outcome benefits versus RV pacing in randomized trials.
Study Design
Type
Observational (n=143)
Multicenter
No
Structured PICO
Does direct left ventricular wire pacing improve procedural outcomes and safety compared to right ventricular lead pacing in patients undergoing transfemoral TAVI?
P
Population
143 consecutive patients (median age 81 years, 61.5% female) with severe aortic stenosis undergoing transfemoral transcatheter aortic valve implantation at a single center.
E
Exposure
Direct left ventricular (LV) wire pacing via preshaped guidewires
C
Comparator
Conventional right ventricular (RV) lead pacing via temporary transvenous pacing electrode
O
Outcome
Efficacy of direct LV wire pacing (systolic pressure drop below 60 mm Hg for more than 30 s without loss of capture)composite
Direct left ventricular wire pacing during TAVI is a safe and effective alternative to right ventricular lead pacing, potentially reducing procedural time and avoiding venous access complications.
Limitations
- Nonrandomized series of patients
- Relatively small population from a single center
- Retrospective study design
- Potential operator bias in the decision on the use of particular pacing techniques
- Balloon-tipped right ventricular pacing electrodes were unavailable during the study period
- Relatively small population from a single TAVI center
- Unavailability of balloon-tipped RV pacing electrodes during the study period
Cite This Study
Stąpór et al. (2020) conducted an observational in Severe aortic stenosis (n=143). Direct left ventricular wire pacing vs. Right ventricular lead pacing was evaluated on Efficacy of direct left ventricular wire pacing (systolic pressure drop below 60 mm Hg for more than 30 s without loss of capture). Direct left ventricular wire pacing during transcatheter aortic valve implantation achieved a 97.6% efficacy rate and was associated with a shorter median procedure time compared to right ventricular lead pacing.
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