Stabilisation of coronary stents using rapid right ventricular pacing

Excessive movement of coronary stents within the artery can make precise stent placement difficult. This study assessed the use of rapid right ventricular pacing to reduce stent motion to improve the accuracy of placement.

During percutaneous coronary intervention, if excessive stent movement prevented accurate stent placement, rapid right ventricular pacing was performed to reduce stent motion within the coronary artery during both stent positioning and deployment. Post procedural angiograms were analysed by two independent operators to measure stent movement during sinus rhythm and during rapid right ventricular pacing. Rapid right ventricular pacing was considered necessary in ten patients. No procedural complications occurred. Mean stent excursion for all patients in sinus rhythm was 2.9 mm (SD 1.6) and during rapid right ventricular pacing this was reduced to 0.8 mm (SD 0.6) (p<0.001). Movement assessed by individual operators ranged from 0.7 to 6.5 mm during sinus rhythm and from 0.1 to 2.4 mm during right ventricular pacing.

Rapid right ventricular pacing is an effective and safe method to reduce stent movement and facilitate accurate stent deployment. This simple technique can be easily applied in any interventional cardiac catheterisation laboratory without the need for additional training or equipment.