Guidewire pacing safely and effectively treats bradyarrhythmias induced by rheolytic thrombectomy and precludes the need for transvenous pacing: the Scott & White experience.
Rheolytic thrombectomy (RT) is useful in certain percutaneous coronary interventions but may be associated with transient bradyarrhythmias. Clinicians have devised numerous strategies to deal with these arrhythmias apart from transvenous right ventricular pacing, some of which are described in other parts of this supplement. We report the Scott & White experience utilizing guidewire pacing to quickly and safely pace the heart in the event of bradyarrhythmia. We found this method to be safe and reliable (96.2% successful) during RT and now use this technique almost exclusively in the cardiac catheterization lab to deal with transient bradyarrhythmias during RT or due to any other cause.We also report an increased incidence of bradyarrhythmia occurring during RT when it is performed in the right coronary artery, with a trend toward an increased incidence during the clinical presentation of ST-elevation myocardial infarction.
Mixon
Timothy A
TA
Texas A&M Health Science Center, Scott & White Clinic, Division of Cardiology, 2401 S. 31st Street, Temple, TX 76504, USA. tmixon@swmail.sw.org
Dehmer
Gregory J
GJ
Santos
Raul A
RA
Gantt
D Scott
DS
Lawrence
Mark E
ME
Watson
Linley E
LE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001919:Bradycardia / Q000209:etiology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003328:Coronary Thrombosis / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D017131:Thrombectomy / Q000009:adverse effects* / Q000379:methods; D013997:Time Factors