Rapid pacing using device programmers: A complex procedural simplification?

Abstract

Key Points• What the article teaches: A sizable proportion of patients undergoing transcatheter valve procedures carry a pacemaker or a defibrillator that can be safely and effectively used to achieve rapid ventricular pacing needed during the procedure.• How it will impact practice: Pacing through the device programmer is a valid strategy that can be adopted in order to reduce the risk of procedural complications. minimalist methods to achieve stable ventricular pacing? Left ventricular pacing via the valve delivery guidewire is being adopted with growing confidence by operators, and was associated with significantly reduced procedure duration, fluoroscopy time, and cost in a randomized trial, with similar efficacy and safety. 3 The Tempo temporary pacing lead (BioTrace Medical, Inc., Menlo Park, CA) has a soft tip and a novel active fixation mechanism designed to enhance lead stability, and preliminary results are promising, although it adds cost to the procedure and a few cases of loss of capture have been reported. 2In conclusion, a single strategy does not fit all the patients, and the paper by Jones et al. 4 provides evidence that RVP via the preimplanted devices is a valid option during transcatheter heart valve interventions. Safety being its major strength, the main drawback is the addition of complexity and of a professional figure. While it certainly represents a nice add to our therapeutic strategy, broadening its adoption in daily practice probably requires stronger demonstration of improved clinical results. ORCID Francesco Saiahttps://orcid.org/0000-0001-9969-2649