El marcapasos se programa con salida máxima (20 V) y sensibilidad anulada. Métodos: La estimulación ventricular izquierda se realiza conectando el extremo externo de una guía Safari 2 preformada situada en el ventrículo izquierdo al cátodo de un marcapasos temporal, y el ánodo al cuerpo de una guía Emerald insertada en la aurícula mediante un catéter Judkins Right diagnóstico a través de un acceso venoso femoral (punción ecoguiada). Nuestro objetivo fue evaluar la eficacia y la seguridad de la estimulación ventricular izquierda a través de la guía de alto soporte utilizada para el implante y una guía situada en la aurícula derecha (AD) que actúa como ánodo. Introducción y objetivos: La estimulación ventricular rápida reduce el gasto cardiaco, proporcionando estabilidad durante el implante percutáneo de válvula aórtica (TAVI). This procedure also provides the advantage of being able to use the central venous access for possible emergency temporary pacemaker implantation. Procedural time did not increase significantly, and the median length of stay after implantation was 2 days.Ĭonclusions: In our series, left ventricular pacing using the RA-positioned wire as the anode proved to be effective and safe without increasing procedural time significantly. No vascular complications from venous access were documented, not even from the RA guidewire. Two patients required a temporary and permanent pacemaker due to high-grade atrioventricular block. Procedure was successful in all cases (there was 1 capture failure due to pacemaker programming). Results: A total of 62 selected patients (median 79.4 ± 6.5 years old) underwent transfemoral TAVI using the pacing technique described (25 patients the SAPIEN 3 Ultra 13 the Navitor, 9 the ACURATE neo2, 14 the Evolut PRO+, and 1 patient the Myvalve). Pacemaker was programmed with maximum output (20 V) and null sensitivity. Methods: Left ventricular pacing is performed by connecting the external end of a Safari 2 pre-shaped guidewire located in the left ventricle to the cathode of a temporary pacemaker, and the anode to the body of an Emerald guidewire inserted into the RA using a diagnostic Judkins Right catheter (via ultrasound-guided femoral venous access). Our objective is to assess the efficacy and safety profile of left ventricular pacing through the high-support guidewire used for implantation and a guidewire located in the right atrium (RA) functioning as an anode. Introduction and objectives: Rapid ventricular pacing reduces cardiac output by providing stability during transcatheter aortic valve implantation (TAVI).
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