Efficacy of left versus traditional right ventricular wire pacing in transcatheter aortic valve replacement: A retrospective cohort study in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Hang ¹ , SHI Mengnan ² , WANG Huajun ¹ , SHI Fengwu ¹ , LIU Suyun ² ,  AN Jinghui ¹

1. Department of Cardiac Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, P. R. China;
2. Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, P. R. China;

Corresponding author：

AN Jinghui, Email: anjinghui2009@126.com

Keywords：

Transcatheter aortic valve replacement; left ventricular guide wire pacing technique; aortic stenosis

DOI：

10.7507/1007-4848.202501059

Video：

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Objective To compare the clinical efficacy of left ventricular wire pacing with traditional right ventricular lead pacing in transcatheter aortic valve replacement. Methods Perioperative data of patients undergoing transcatheter aortic valve replacement at the Second Hospital of Hebei Medical University from January 2022 to June 2023 were collected. Patients were divided into a left ventricular wire pacing group and a right ventricular lead pacing group based on the pacing method during the procedure, and the clinical data of the two groups were compared and analyzed. Results A total of 102 patients were included, with 35 patients in the left ventricular wire pacing group [20 males and 15 females, age (69.2±3.1) years] and 67 patients in the right ventricular lead pacing group [37 males and 30 females, age (70.2±3.7) years]. The hemodynamic characteristics of both groups (peak flow velocity, peak transvalve pressure difference, left ventricular ejection fraction) showed significant improvement post-operation compared to pre-operation (P<0.05). There was no statistically significant difference between the two groups in terms of pacing success rate and surgical complications (P>0.05). Compared to the right ventricular lead pacing group, the left ventricular wire pacing group had shorter operation time [(76.3±17.2) min vs. (86.1±15.3) min, P=0.004] and X-ray exposure time [(18.2±6.1) min vs. (26.2±4.3) min, P<0.001], and lower total hospitalization cost [(213±28) thousand yuan vs. (262±25) thousand yuan, P<0.001]. Conclusion The safety and reliability of left ventricular wire pacing in transcatheter aortic valve replacement are similar to those of traditional right ventricular lead pacing. Moreover, it can significantly reduce the operation and X-ray exposure time and decrease the total clinical hospitalization cost, making it a viable alternative to traditional right ventricular lead pacing.

1.	Hilling-Smith R, Cockburn J, Dooley M, et al. Rapid pacing using the 0. 035-in. retrograde left ventricular support wire in 208 cases of transcatheter aortic valve implantation and balloon aortic valvuloplasty. Catheter Cardiovasc Interv, 2017, 89(4): 783-786.
2.	中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术中国专家共识(2020更新版). 中国介入心脏病学杂志, 2020, 28(6): 301-309.Structural Heart Disease Professional Committee, Branch of Cardiovascular Physicians, Chinese Medical Doctor Association. Chinese expert consensus on transcatheter aortic valve replacement (2020 Update edition). Chin J Intervent Cardiol, 2020, 28(6): 301-309.
3.	中国医师协会心血管内科医师分会结构性心脏病学组, 亚太结构性心脏病俱乐部. 中国经导管主动脉瓣置换术临床路径专家共识 (2024版). 中国胸心血管外科临床杂志, 2024, 31(12): 1713-1727.Structural Cardiology Group, Branch of Cardiovascular Physicians, Chinese Medical Doctor Association, Asia Pacific Structural Heart Disease Club. Expert Consensus on Clinical pathways for transcatheter aortic valve replacement in China (2024 edition). Chin J Clin Thorac Cardiovasc Surg, 2024, 31(12): 1713-1727.
4.	中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识(2021版). 中国循环杂志, 2022, 37(1): 12-23.Structural Heart Disease Professional Committee, Branch of Cardiovascular Physicians, Chinese Medical Doctor Association. Expert Consensus on Clinical Pathways for Transcatheter aortic valve Replacement in China (2021 edition). Chin Circ J, 2022, 37(1): 12-23.
5.	Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement in low-risk patients at five years. N Engl J Med, 2023, 389(21): 1949-1960.
6.	宋光远, 赵跃武, 杜国勇, 等. 股动脉路径经导管主动脉瓣置换术式简化的单中心经验. 中华心血管病杂志, 2022, 50(6): 563-569.Song GY, Zhao YW, Du GY, et al. Simple single-center experience of femoral artery route transcatheter aortic valve replacement. Chin J Cardiol, 2022, 50(6): 563-569.
7.	赵振燕, 张洪亮, 张喆, 等. 在单纯局部麻醉下行经导管主动脉瓣置换术可行性和安全性的初步研究. 中国循环杂志, 2022, 37(4): 341-347.Zhao ZY, Zhang HL, Zhang Z, et al. Preliminary study on the feasibility and safety of transcatheter aortic valve replacement under local anesthesia alone. Chin Circ J, 2022, 37(4): 341-347.
8.	陈阳, 王墨扬, 牛冠男, 等. 中国首例完全局部麻醉且无镇静下极简式经导管主动脉瓣置换术. 中国循环杂志, 2021, 36(10): 1027-1030.Chen Y, Wang MY, Niu GN, et al. The first simple transcatheter aortic valve replacement under complete local anesthesia without sedation in China. Chin Circ J, 2021, 36(10): 1027-1030.
9.	Faurie B, Abdellaoui M, Wautot F, et al. Rapid pacing using the left ventricular guidewire: reviving an old technique to simplify BAV and TAVI procedures. Catheter Cardiovasc Interv, 2016, 88(6): 988-993.
10.	Hilling-Smith R, Cockburn J, Dooley M, et al. Rapid pacing using the 0. 035-in. retrograde left ventricular support wire in 208 cases of transcatheter aortic valve implantation and balloon aortic valvuloplasty. Catheter Cardiovasc Interv, 2017, 89(4): 783-786.
11.	Faurie B, Souteyrand G, Staat P, et al. Left ventricular rapid pacing via the valve delivery guidewire in transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2019, 12(24): 2449-2459.
12.	McCann P. A review of temporary cardiac pacing wires. Indian Pacing Electrophysiol J, 2007, 7(1): 40-49.
13.	宋光远, 刘新民, 滕思勇, 等. 使用左心室导丝起搏技术行经导管主动脉瓣置换术. 中华心血管病杂志, 2021, 49(5): 461-466.Song GY, Liu XM, Teng SY, et al. Transcatheter aortic valve replacement using left ventricular wire pacing. Chin J Cardiol, 2021, 49(5): 461-466.
14.	刘新民, 宋光远, 滕思勇, 等. 使用左心室导丝起搏技术行经导管主动脉瓣置换术联合经皮冠状动脉介入治疗一站式手术一例. 中国循环杂志, 2020, 35(12): 1250-1252.Liu XM, Song GY, Teng SY, et al. One case of transcatheter aortic valve replacement combined with percutaneous coronary intervention using left ventricular wire pacing. Chin Circ J, 2020, 35(12): 1250-1252.
15.	张航, 安景辉, 刘苏, 等. 应用左心室导丝起搏技术行经导管主动脉瓣置换术治疗高龄主动脉瓣狭窄1例. 中华老年医学杂志, 2023, 42(12): 1483-1484.Zhang H, An JH, Liu S, et al. Transcatheter aortic valve replacement using left ventricular wire pacing technique in the treatment of elderly patients with aortic stenosis. Chin J Geriatr, 2023, 42(12): 1483-1484.

1. Hilling-Smith R, Cockburn J, Dooley M, et al. Rapid pacing using the 0. 035-in. retrograde left ventricular support wire in 208 cases of transcatheter aortic valve implantation and balloon aortic valvuloplasty. Catheter Cardiovasc Interv, 2017, 89(4): 783-786.
2. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术中国专家共识(2020更新版). 中国介入心脏病学杂志, 2020, 28(6): 301-309.Structural Heart Disease Professional Committee, Branch of Cardiovascular Physicians, Chinese Medical Doctor Association. Chinese expert consensus on transcatheter aortic valve replacement (2020 Update edition). Chin J Intervent Cardiol, 2020, 28(6): 301-309.
3. 中国医师协会心血管内科医师分会结构性心脏病学组, 亚太结构性心脏病俱乐部. 中国经导管主动脉瓣置换术临床路径专家共识 (2024版). 中国胸心血管外科临床杂志, 2024, 31(12): 1713-1727.Structural Cardiology Group, Branch of Cardiovascular Physicians, Chinese Medical Doctor Association, Asia Pacific Structural Heart Disease Club. Expert Consensus on Clinical pathways for transcatheter aortic valve replacement in China (2024 edition). Chin J Clin Thorac Cardiovasc Surg, 2024, 31(12): 1713-1727.
4. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识(2021版). 中国循环杂志, 2022, 37(1): 12-23.Structural Heart Disease Professional Committee, Branch of Cardiovascular Physicians, Chinese Medical Doctor Association. Expert Consensus on Clinical Pathways for Transcatheter aortic valve Replacement in China (2021 edition). Chin Circ J, 2022, 37(1): 12-23.
5. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement in low-risk patients at five years. N Engl J Med, 2023, 389(21): 1949-1960.
6. 宋光远, 赵跃武, 杜国勇, 等. 股动脉路径经导管主动脉瓣置换术式简化的单中心经验. 中华心血管病杂志, 2022, 50(6): 563-569.Song GY, Zhao YW, Du GY, et al. Simple single-center experience of femoral artery route transcatheter aortic valve replacement. Chin J Cardiol, 2022, 50(6): 563-569.
7. 赵振燕, 张洪亮, 张喆, 等. 在单纯局部麻醉下行经导管主动脉瓣置换术可行性和安全性的初步研究. 中国循环杂志, 2022, 37(4): 341-347.Zhao ZY, Zhang HL, Zhang Z, et al. Preliminary study on the feasibility and safety of transcatheter aortic valve replacement under local anesthesia alone. Chin Circ J, 2022, 37(4): 341-347.
8. 陈阳, 王墨扬, 牛冠男, 等. 中国首例完全局部麻醉且无镇静下极简式经导管主动脉瓣置换术. 中国循环杂志, 2021, 36(10): 1027-1030.Chen Y, Wang MY, Niu GN, et al. The first simple transcatheter aortic valve replacement under complete local anesthesia without sedation in China. Chin Circ J, 2021, 36(10): 1027-1030.
9. Faurie B, Abdellaoui M, Wautot F, et al. Rapid pacing using the left ventricular guidewire: reviving an old technique to simplify BAV and TAVI procedures. Catheter Cardiovasc Interv, 2016, 88(6): 988-993.
10. Hilling-Smith R, Cockburn J, Dooley M, et al. Rapid pacing using the 0. 035-in. retrograde left ventricular support wire in 208 cases of transcatheter aortic valve implantation and balloon aortic valvuloplasty. Catheter Cardiovasc Interv, 2017, 89(4): 783-786.
11. Faurie B, Souteyrand G, Staat P, et al. Left ventricular rapid pacing via the valve delivery guidewire in transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2019, 12(24): 2449-2459.
12. McCann P. A review of temporary cardiac pacing wires. Indian Pacing Electrophysiol J, 2007, 7(1): 40-49.
13. 宋光远, 刘新民, 滕思勇, 等. 使用左心室导丝起搏技术行经导管主动脉瓣置换术. 中华心血管病杂志, 2021, 49(5): 461-466.Song GY, Liu XM, Teng SY, et al. Transcatheter aortic valve replacement using left ventricular wire pacing. Chin J Cardiol, 2021, 49(5): 461-466.
14. 刘新民, 宋光远, 滕思勇, 等. 使用左心室导丝起搏技术行经导管主动脉瓣置换术联合经皮冠状动脉介入治疗一站式手术一例. 中国循环杂志, 2020, 35(12): 1250-1252.Liu XM, Song GY, Teng SY, et al. One case of transcatheter aortic valve replacement combined with percutaneous coronary intervention using left ventricular wire pacing. Chin Circ J, 2020, 35(12): 1250-1252.
15. 张航, 安景辉, 刘苏, 等. 应用左心室导丝起搏技术行经导管主动脉瓣置换术治疗高龄主动脉瓣狭窄1例. 中华老年医学杂志, 2023, 42(12): 1483-1484.Zhang H, An JH, Liu S, et al. Transcatheter aortic valve replacement using left ventricular wire pacing technique in the treatment of elderly patients with aortic stenosis. Chin J Geriatr, 2023, 42(12): 1483-1484.

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Latest ArticlesEfficacy of left versus traditional right ventricular wire pacing in transcatheter aortic valve replacement: A retrospective cohort study in a single center

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