Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, Canada.
Department of Interventional Cardiology, Sutter Health, San Francisco, California, USA.
Catheter Cardiovasc Interv. 2020 Oct 1;96(4):968-971. doi: 10.1002/ccd.28832. Epub 2020 Mar 9.
To assess the safety and efficacy of the Wattson temporary pacing guidewire.
Transcatheter aortic valve replacement (TAVR) requires a guidewire for device delivery and generally requires temporary pacing wire for burst and back-up pacing. The Wattson wire provides concomitant support and bipolar pacing without the need to place a temporary venous pacemaker (TVP).
This was a single-center nonrandomized prospective clinical trial enrolling 20 patients. The primary endpoint was defined as successful rapid pacing and transcatheter heart valve (THV) delivery with no loss of capture. Safety, qualitative and quantitative secondary outcomes were also analyzed.
Mean age was 77.4 ± 9.0 years. Mean Society of Thoracic Surgery (STS) score was 3.0 ± 1.5%. All patients received a balloon-expandable valve via a transfemoral approach. All patients met the primary end-point. One patient (5%) had balloon predilatation and six patients (30%) had postdilatation, all using the wire. Mean pacing threshold was 2.2 ± 1.2 mA that was evaluated prior to placing an insulating catheter over the wire. One patient required TVP placement and subsequent permanent pacemaker implantation due to complete heart block post THV deployment. There were no incidences of cardiac perforation or tamponade. One patient required valve reintervention, which was not related to the device.
The Wattson wire offered predictable guidewire support with concomitant reliable bipolar pacing at low thresholds to allow safe THV delivery in this patient cohort. It has the potential to make TAVR a safer and more efficient procedure.
评估 Wattson 临时起搏导丝的安全性和有效性。
经导管主动脉瓣置换术（TAVR）需要导丝进行器械输送，通常需要临时起搏线进行突发和备用起搏。Wattson 导丝提供了伴随的支持和双极起搏，而无需放置临时静脉起搏器（TVP）。
这是一项单中心、非随机的前瞻性临床试验，共纳入 20 例患者。主要终点定义为成功的快速起搏和经导管心脏瓣膜（THV）输送，且不失夺获。还分析了安全性、定性和定量的次要结局。
平均年龄为 77.4±9.0 岁。平均胸外科医生协会（STS）评分 3.0±1.5%。所有患者均经股动脉入路接受球囊扩张瓣膜。所有患者均达到主要终点。1 名患者（5%）进行了球囊预扩张，6 名患者（30%）进行了后扩张，均使用了导丝。起搏阈值平均为 2.2±1.2 mA，在将绝缘导管放置在导丝上之前进行了评估。1 名患者因 THV 植入后完全性心脏阻滞而需要放置 TVP 并随后植入永久性起搏器。无心脏穿孔或心脏压塞的发生。1 名患者需要再次进行瓣膜介入治疗，但与器械无关。
Wattson 导丝在该患者队列中提供了可预测的导丝支持，并具有可靠的双极起搏，起搏阈值低，可确保安全的 THV 输送。它有可能使 TAVR 成为更安全、更有效的手术。
