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.	中國醫師協會心血管內科醫師分會結構性心臟病專業委員會. 經導管主動脈瓣置換術中國專家共識(2020更新版). 中國介入心臟病學雜志, 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.	中國醫師協會心血管內科醫師分會結構性心臟病學組, 亞太結構性心臟病俱樂部. 中國經導管主動脈瓣置換術臨床路徑專家共識 (2024版). 中國胸心血管外科臨床雜志, 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.	中國醫師協會心血管內科醫師分會結構性心臟病專業委員會. 中國經導管主動脈瓣置換術臨床路徑專家共識(2021版). 中國循環雜志, 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.	宋光遠, 趙躍武, 杜國勇, 等. 股動脈路徑經導管主動脈瓣置換術式簡化的單中心經驗. 中華心血管病雜志, 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.	趙振燕, 張洪亮, 張喆, 等. 在單純局部麻醉下行經導管主動脈瓣置換術可行性和安全性的初步研究. 中國循環雜志, 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.	陳陽, 王墨揚, 牛冠男, 等. 中國首例完全局部麻醉且無鎮靜下極簡式經導管主動脈瓣置換術. 中國循環雜志, 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.	宋光遠, 劉新民, 滕思勇, 等. 使用左心室導絲起搏技術行經導管主動脈瓣置換術. 中華心血管病雜志, 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.	劉新民, 宋光遠, 滕思勇, 等. 使用左心室導絲起搏技術行經導管主動脈瓣置換術聯合經皮冠狀動脈介入治療一站式手術一例. 中國循環雜志, 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.	張航, 安景輝, 劉蘇, 等. 應用左心室導絲起搏技術行經導管主動脈瓣置換術治療高齡主動脈瓣狹窄1例. 中華老年醫學雜志, 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. 中國醫師協會心血管內科醫師分會結構性心臟病專業委員會. 經導管主動脈瓣置換術中國專家共識(2020更新版). 中國介入心臟病學雜志, 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. 中國醫師協會心血管內科醫師分會結構性心臟病學組, 亞太結構性心臟病俱樂部. 中國經導管主動脈瓣置換術臨床路徑專家共識 (2024版). 中國胸心血管外科臨床雜志, 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. 中國醫師協會心血管內科醫師分會結構性心臟病專業委員會. 中國經導管主動脈瓣置換術臨床路徑專家共識(2021版). 中國循環雜志, 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. 宋光遠, 趙躍武, 杜國勇, 等. 股動脈路徑經導管主動脈瓣置換術式簡化的單中心經驗. 中華心血管病雜志, 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. 趙振燕, 張洪亮, 張喆, 等. 在單純局部麻醉下行經導管主動脈瓣置換術可行性和安全性的初步研究. 中國循環雜志, 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. 陳陽, 王墨揚, 牛冠男, 等. 中國首例完全局部麻醉且無鎮靜下極簡式經導管主動脈瓣置換術. 中國循環雜志, 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. 宋光遠, 劉新民, 滕思勇, 等. 使用左心室導絲起搏技術行經導管主動脈瓣置換術. 中華心血管病雜志, 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. 劉新民, 宋光遠, 滕思勇, 等. 使用左心室導絲起搏技術行經導管主動脈瓣置換術聯合經皮冠狀動脈介入治療一站式手術一例. 中國循環雜志, 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. 張航, 安景輝, 劉蘇, 等. 應用左心室導絲起搏技術行經導管主動脈瓣置換術治療高齡主動脈瓣狹窄1例. 中華老年醫學雜志, 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.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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