title: Rapid pacing using the 0.035-in. Retrograde left ventricular support wire in 208 cases of transcatheter aortic valve implantation and balloon aortic valvuloplasty.
abstract: METHODS
  Transcatheter aortic valve implantation (TAVI) and balloon aortic valvuloplasty (BAV) are now well established percutaneous procedures. These procedures almost always require bursts of rapid ventricular pacing to temporarily reduce cardiac output to facilitate the procedure, usually done via a temporary pacing wire inserted into the right ventricle. We describe a case series of 132 cases of TAVI and 76 BAV done using ventricular pacing via the left ventricular lead by simply connecting one electrode to the patient's skin and one electrode through the left ventricular (LV) wire.
  
  
  RESULTS
  All of the 132 TAVI cases (a mixture of Edwards Sapien, Medtronic CoreValve and Boston Scientific Lotus) and 76 BAV were successfully performed using pacing through the LV wire. No BAV patients required temporary pacing wire (TPW) or permanent pacemaker (PPM) insertion. Of the TAVI patients, 6 (4.5%) required TPW during the procedure due to complete heart block to facilitate removal of the LV wire. 1 patient (0.8%) required a PPM urgently due to complete heart block and haemodynamic instability. Twenty eight Patients (21.2%) required PPM following TAVI, 9 of which were within the first 24 hr. Average time to pacemaker implantation was 3.7 days.
  
  
  CONCLUSIONS
  Rapid ventricular pacing via the LV wire is a simple, safe and effective strategy for percutaneous aortic valve intervention and balloon aortic valvuloplasty. It eliminates the need for a temporary pacing wire with its attendant risks in the vast majority of cases. Furthermore, most pacemakers following TAVI are required late, after the first 24 hr period, by which time the TPW has already usually been removed. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: Roland
authors.initials: R
authors.lastname: Hilling-Smith
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Cockburn
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: Maureen
authors.initials: M
authors.lastname: Dooley
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: Jessica
authors.initials: J
authors.lastname: Parker
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: Andrea
authors.initials: A
authors.lastname: Newton
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hill
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: Uday
authors.initials: U
authors.lastname: Trivedi
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: Adam
authors.initials: A
authors.lastname: de Belder
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Hildick-Smith
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D063126:Balloon Valvuloplasty / Q000379:methods*; D002302:Cardiac Output / Q000502:physiology; D005260:Female; D006327:Heart Block / Q000209:etiology / Q000517:prevention & control*; D006339:Heart Rate / Q000502:physiology; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome
keywords: Balloon valvuloplasty; TAVI; TAVR; Temporary Pacing Wire; pacemaker