Coronary artery narrowings interfere with blood flow to the heart which can cause chest pain and heart attacks. Cardiologists can treat these narrowings with balloons and stents. However, some narrowings can become very calcified and hard making treatment with balloons and stents difficult. Rotational atherectomy is a tool to treat calcific coronary disease. It uses an ablative drill to break down the hardened plaques inside the coronary arteries facilitating subsequent treatment with balloons and stents. However, during this procedure patients can experience a slow heart rate which may compromise procedural safety. Cardiologists may use a temporary pacemaker that is inserted by separately accessing the heart through a large vein usually from the leg. This maintains a safe heart rate throughout the procedure. However, inserting the temporary pacemaker is associated with additional complications. We have developed and propose an alternative strategy to provide a temporary safety pacemaker during rotational atherectomy without the need for inserting an additional pacemaker.
Study Type
OBSERVATIONAL
Enrollment
100
Royal Jubilee Hospital
Victoria, British Columbia, Canada
RECRUITINGSuccessful ventricular pacing
Ability to obtain successful ventricular capture prior to rotational atherectomy
Time frame: At the start of the PCI procedure immediately prior to rotational atherectomy
Ventricular pacing threshold
The pacing threshold to obtain successful ventricular capture
Time frame: At the start of the PCI procedure immediately prior to rotational atherectomy
Complications
(a) Coronary wire-related intractable spasm (unresponsive to vasodilator therapy); (b) coronary wire-related perforation; (c) New atrial or ventricular arrhythmia
Time frame: At the end of the PCI procedure
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