Chatelain P, Meier B, Bélenger J, Killisch J P, Cox J N, Rutishauser W
Arch Mal Coeur Vaiss. 1985 Oct;78(10):1583-7.
Percutaneous coronary angioplasty (PCA) is sometimes complicated by bradyarrhythmias necessitating emergency temporary cardiac pacing. This is usually performed by the classical transvenous endocardial approach. This experimental study investigated the possibility of using the metallic guide wire used during PCA as a monopolar electrode. Systematic electrical stimulation at different levels of the coronary arteries in 6 anaesthetised pigs showed threshold levels in the distal segments of 3 to 15 mA, close to the values observed in the right ventricule. Short periods of pacing were well tolerated. On the other hand, prolonged pacing (2 to 5 days) invariably led to the formation of a thrombus in the coronary segment occupied by the metallic guide wire and so should be avoided. This study shows that the metallic guide wire can be used as an emergency pacing electrode during PCA but this should be limited to a short period. This technique could replace the systematic introduction of classical transvenous pacing catheters.
经皮冠状动脉腔内血管成形术（PCA）有时会并发缓慢性心律失常，需要进行紧急临时心脏起搏。这通常通过经典的经静脉心内膜途径来完成。本实验研究探讨了在PCA期间使用的金属导丝作为单极电极的可能性。对6只麻醉猪的冠状动脉不同水平进行系统性电刺激，结果显示远端节段的阈值水平为3至15毫安，接近在右心室观察到的值。短时间起搏耐受性良好。另一方面，长时间起搏（2至5天）总是会导致金属导丝所在冠状动脉节段形成血栓，因此应避免。本研究表明，金属导丝可在PCA期间用作紧急起搏电极，但应限于短时间使用。该技术可替代常规经静脉起搏导管的系统性置入。
