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Comparison of left ventricular pacing performance among pre-shaped guidewires designed for transfemoral-approach transcatheter aortic valve implantation

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Abstract

TAVI is an established therapy for patients with severe aortic stenosis. Rapid or control pacing is necessary for TAVI, and most centers are familiar with right ventricular (RV) pacing. Although there are several reports on the efficacy and safety of LV pacing, they are still few. In addition, LV pacing has not been studied for different LV guidewires. Our aim is to study the effectiveness of left ventricular (LV) pacing and the thresholds of LV guidewires in patients who underwent transcatheter aortic valve implantation (TAVI). We retrospectively analyzed 252 consecutive patients who underwent trans-femoral TAVI (TF-TAVI) with LV pacing in our institute between December 2017 and November 2020. We excluded 48 patients from the total cohort due to TAVI with RV pacing, and the remaining 204 patients were analyzed (52 males, mean age 85 ± 5 years). Among them, 202 patients (99.0%) had successful LV pacing. In the two patients with failed LV pacing, SAFARI2™ Small was used. The CONFIDA™ group (n = 34) showed a significantly lower threshold than the SAFARI2™ group (n = 163) (median 3.0 vs. 5.0 V; P = 1.1 × 10–7). LV pacing with Lunderquist® was successful in all patients (n = 7). LV pacing in TAVI was an effective and safe strategy. CONFIDA™ wire may be particularly well suited for LV pacing in TAVI.

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Acknowledgements

We would like to express our gratitude to all of the participants and staff members involved in this study.

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Authors and Affiliations

  1. Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan

    Yudai Tamura, Yutaka Konami, Hiroto Suzuyama, Eiji Horio, Masahiro Yamada, Eiji Taguchi, Yoko Horibata & Tomohiro Sakamoto

  2. Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan

    Toshiharu Sassa & Ichiro Ideta

  3. Department of Cardiology, International University of Health and Welfare School of Medicine, Narita, Japan

    Yudai Tamura, Yuichi Tamura & Akio Kawamura

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  1. Yudai Tamura
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  2. Yuichi Tamura
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  3. Yutaka Konami
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  4. Hiroto Suzuyama
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  12. Tomohiro Sakamoto
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Correspondence to Tomohiro Sakamoto.

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Approval of the research protocol: the study protocol was approved by the ethics committee of Saiseikai Kumamoto Hospital (approval number 935).

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Tamura, Y., Tamura, Y., Konami, Y. et al. Comparison of left ventricular pacing performance among pre-shaped guidewires designed for transfemoral-approach transcatheter aortic valve implantation. Heart Vessels 37, 460–466 (2022). https://doi.org/10.1007/s00380-021-01938-4

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  • DOI: https://doi.org/10.1007/s00380-021-01938-4

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