title: Coronary stent immobilization during angioplasty by transcoronary ventricular pacing via a guidewire.
abstract: OBJECTIVE
  In some patients, cardiac contractions cause the coronary artery segment adjacent to a stent to move in such a way that accurate stent positioning is difficult. A number of techniques have been described for immobilizing the stent at the target site by inducing periods of either asystole or tachycardia. This study shows how pulsatile motion can be controlled by means of rapid ventricular pacing via an angioplasty guidewire.
  
  
  METHODS
  The study involved 27 consecutive patients in whom excessive stent movement during angioplasty complicated accurate stent implantation. In these selected patients, myocardial tachycardia was induced by transcoronary ventricular pacing via an angioplasty guidewire with the aim of reducing the pulsatile motion of the stent.
  
  
  RESULTS
  At baseline, the median displacement was 4.08 mm (interquartile range 2.75 mm). During pacing at 100 and 150 beats per minute, the median displacement was 1.39 mm and 0.54 mm, respectively (interquartile range 1.66 mm and 0.54 mm, respectively). Transcoronary myocardial pacing was effective in 96% of cases. No complications associated with pacing were reported.
  
  
  CONCLUSIONS
  Transcoronary ventricular pacing via an angioplasty guidewire was an effective and safe method for achieving stent immobilization in cases where there was excessive pulsatile motion.
authors.affiliation: Servicio de Hemodinámica y Cardiología Intervencionista, Policlínica Gipuzkoa, 20009 San Sebastián, Guipúzcoa, Spain. glasa@med.policlinicagipuzkoa.com
authors.forename: Garikoitz
authors.initials: G
authors.lastname: Lasa
authors.forename: Mariano
authors.initials: M
authors.lastname: Larman
authors.forename: Koldo
authors.initials: K
authors.lastname: Gaviria
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Sanmartín
authors.forename: Mario
authors.initials: M
authors.lastname: Sádaba
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Rumoroso
mesh_terms: D017130:Angioplasty; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D003327:Coronary Disease / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome