Management of dysrhythmias during coronary AngioJet: how to minimize the need for temporary pacemaker during rheolytic thrombectomy.
BACKGROUND
Whatever the mechanism or mechanisms involved in the genesis of bradyarrhythmias during rheolytic thrombectomy (RT), the severity and duration of bradycardia are related to vessel location and the duration of the activation of the RT catheter. The latter implies that procedural variables may have a role in the prevention or attenuation of bradycardia and subsequent minimization of the need for temporary pacemaker insertion.


METHODS
From January 2004 to December 2007, 396 patients with ST-segment elevation acute myocardial infarction received RT using the single-pass anterograde technique. All but 2 patients had RT without temporary pacemaker support. The 2 patients with temporary pacemakers received the electrical support before arriving in the cath lab.


RESULTS
No major clinical adverse events related to bradyarrhythmias occurred.


CONCLUSIONS
The single-pass anterograde RT technique minimizes the need for temporary pacemaker insertion and is safe and effective.
Antoniucci
David
D
Careggi Hospital, Viale Morgagni, Florence, I-50134, Italy. david.antoniucci@virgilio.it
D001919:Bradycardia / Q000209:etiology / Q000517:prevention & control*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003328:Coronary Thrombosis / Q000628:therapy*; D006801:Humans; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D017131:Thrombectomy / Q000009:adverse effects* / Q000379:methods