Key result
Rapid ventricular pacing linked to ~77% less stent delivery system motion without hemodynamic degeneration or arrhythmias.
Why the study?
Difficulty in stent positioning due to extensive movement of the stent delivery system during PCI can prevent precise deployment, motivating assessment of rapid ventricular pacing.
Does rapid ventricular pacing reduce heart motion and facilitate precise stent positioning in patients undergoing PCI with extensive movement of the stent delivery system?
Observational (n=7)
Does rapid ventricular pacing reduce heart motion and facilitate precise stent positioning in patients undergoing PCI with extensive movement of the stent delivery system?
Absolute Event Rate: 1.7% vs 7.3%
p-value: p=<0.001
Rapid ventricular pacing is a safe and effective technique to reduce heart motion and facilitate precise stent deployment during PCI.
May facilitate precise stent positioning in select PCI cases with excessive motion; leaves open confirmation in prospective trials.
AIMS: We have sometimes encountered difficulty in stent positioning, and managed to achieve optimal positioning of the stent by luck when there was extensive movement of the stent delivery system in association with the cardiac cycle. We assessed the safety and efficacy of rapid ventricular pacing in order to achieve precise positioning of the stent in this percutaneous coronary intervention (PCI) situation. METHODS AND RESULTS: Among 363 patients who underwent PCI, difficulty in positioning of the stent was encountered in 7 consecutive patients due to extensive movement of the stent delivery system. We applied rapid ventricular pacing in these 7 patients. We measured the length of motion of the stent delivery system relative to the coronary artery and systolic blood pressure before and under rapid ventricular pacing at a rate of 160 min-1. The extent of motion was markedly reduced by rapid ventricular pacing (7.3+/-2.6 mm to 1.7+/-0.6 mm; p<0.001). Systolic blood pressure was decreased slightly by rapid ventricular pacing (116+/-15 mmHg to 90+/-7 mmHg; p=0.002), but there were no cases of haemodynamic degeneration or ventricular arrhythmia. CONCLUSIONS: Rapid ventricular pacing is a safe and promising option for precise stent positioning, when movement of the stent delivery system prevents precise deployment.
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Okamura et al. (2007) conducted an observational in Difficulty in stent positioning during PCI (n=7). Rapid ventricular pacing vs. Baseline (before pacing) was evaluated on Length of motion of the stent delivery system relative to the coronary artery (p=<0.001). Rapid ventricular pacing significantly reduced the extent of stent delivery system motion from 7.3 mm to 1.7 mm (p<0.001) without causing hemodynamic degeneration or ventricular arrhythmia.
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