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Temporary coronary guidewire pacing during percutaneous coronary intervention
Timothy A Mixon1, Donald S Cross, Mark E Lawrence
1Department of Medicine, Scott and White Hospital and Clinic, Temple, Texas 76508, USA. tmixon@swmail.sw.org
Summary
Temporary pacing during percutaneous coronary interventions can be achieved using coronary guidewires, offering a simpler alternative to transvenous pacing. This method proved successful and safe in patients, though wire resistance varied.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Temporary pacing is sometimes needed during percutaneous coronary interventions (PCIs).
- Current methods, like transvenous pacing, carry risks and inconvenience.
- Coronary guidewire pacing, described previously, is underutilized.
Purpose of the Study:
- To evaluate the feasibility and safety of temporary pacing using coronary guidewires with currently available equipment.
- To compare guidewire pacing with traditional transvenous pacing methods.
Main Methods:
- Guidewire pacing was assessed in 26 patients undergoing PCI.
- Bench testing was performed on various coronary guidewires to measure electrical resistance.
- Ventricular capture thresholds were evaluated.
Main Results:
- Guidewire pacing was successful in all 26 patients.
- Not all tested guidewires achieved acceptable ventricular capture thresholds due to high resistance.
- No complications were reported during guidewire pacing.
- Bench testing identified several guidewires with potentially unsuitable high resistance.
Conclusions:
- Temporary guidewire pacing is a feasible and safe alternative to transvenous pacing during PCI.
- The choice of guidewire is critical for successful ventricular capture.
- Further investigation into guidewire properties for pacing is warranted.