Aims/objective: Coronary guide wires can be used for pacing the left ventricle during coronary angioplasty, however the experience with modern coronary guide wires as pacing wires is limited. The aim of this study was to determine the safety and efficacy of currently used coronary guide wires for transcoronary pacing.
Methods and results: Transcoronary pacing was tested in 25 patients who were scheduled to undergo elective coronary angioplasty. Four different coronary guide wires were tested using an adaptive alligator clip connecting the guide wire to the pulse generator. Resistance of various guide wires was also measured ex vivo at 150, 175 and 190 cms from the tip respectively. BMW and Galeo wires were used in 12 and 11 patients respectively while Couger and Magic wire were used in one patient each. Pacing was successful in all patients with no pacing related complication. Most patients had unifocal ventricular ectopics. Mean threshold varied between 4 mA to 5.54 mA. Resistance varied from 12 ohms to 31 ohms depending upon the wire and distance from the tip.
Conclusion: Transcoronary pacing using modern coronary guide wires appears to be dependable, well tolerated and safe temporary measure for significant bradyarrhythmias.