title: Rapid ventricular pacing can reduce heart motion and facilitate stent deployment to the optimal position during coronary artery stenting: initial experience.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Okamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Iwakura
authors.forename: Shigeo
authors.initials: S
authors.lastname: Kawano
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kurotobi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Koyama
authors.forename: Motoo
authors.initials: M
authors.lastname: Date
authors.forename: Koichi
authors.initials: K
authors.lastname: Inoue
authors.forename: Toshio
authors.initials: T
authors.lastname: Ogihara
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii