Laird J R, Hull R, Stajduhar K C, Weston L T, Kufs W, Wortham D C
Cardiology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001.
Cathet Cardiovasc Diagn. 1993 Oct;30(2):162-5. doi: 10.1002/ccd.1810300217.
Severe bradyarrhythmias are a rare but potentially life threatening complication of percutaneous transluminal coronary angioplasty (PTCA). Previous work has outlined a technique for coronary pacing using the angioplasty guidewire. To examine the effectiveness of this technique during severe ischemia, seven swine underwent placement of an unmodified 0.014 inch angioplasty guidewire and 3.0 mm balloon catheter in the left anterior descending (LAD) artery. Baseline pacing thresholds were obtained. Pacing was begun at twice diastolic threshold and ischemia was produced by balloon inflation. Repeat capture thresholds were obtained after 1 and 8 minutes of ischemia. Transcoronary pacing was successfully performed in all seven animals and was continued for a mean of 13.8 +/- 1.5 minutes. The baseline capture threshold was 4.0 +/- 0.5 mA. The mean capture threshold was 3.3 +/- 0.3 mA and 4.5 +/- 0.9 mA at 1 and 8 minutes of ischemia, respectively. We conclude that transcoronary pacing using the angioplasty guidewire can be successfully performed during myocardial ischemia and may serve as a reliable backup system during interventional procedures complicated by bradyarrhythmias.
严重缓慢性心律失常是经皮腔内冠状动脉成形术（PTCA）罕见但可能危及生命的并发症。先前的研究概述了一种使用血管成形术导丝进行冠状动脉起搏的技术。为了研究该技术在严重缺血期间的有效性，对7头猪在左前降支（LAD）动脉中置入未改良的0.014英寸血管成形术导丝和3.0毫米球囊导管。获得基线起搏阈值。以两倍舒张期阈值开始起搏，并通过球囊充气产生缺血。在缺血1分钟和8分钟后获得重复捕获阈值。所有7只动物均成功进行了经冠状动脉起搏，平均持续13.8±1.5分钟。基线捕获阈值为4.0±0.5毫安。缺血1分钟和8分钟时的平均捕获阈值分别为3.3±0.3毫安和4.5±0.9毫安。我们得出结论，使用血管成形术导丝进行经冠状动脉起搏可在心肌缺血期间成功进行，并可作为心律失常并发症介入手术期间可靠的备用系统。
