INTRODUCTION
Ventricular pacing for balloon stabilization in aortic valvuloplasty is increasingly used. We sought to evaluate its safety and benefits in a children population.
METHODS
Retrospective review of ten year experience in three pediatric centers.
Control group was obtained based on age of patients and catheterizer in a match proportion of 2 non-paced to 1 paced procedure.
RESULTS
Overall, 140 procedures were performed in 130 patients with mean follow-up time of 32,07 ± 34,98 months . There was male predominance (68,3%) with mean age of 5,6±6,97 years, and mean weight of 24,24±26,68 kg at procedure. Ventricular pacing has been used in 23 aortic valvuloplasties (16,4%) since 2003.
Paced patients and control group were similar for procedure duration, radiation time and final gradient relief measured by echocardiography and catheterization. Non-paced procedures were much more associated with multiple (>3) balloon inflations (41,3% vs. 4,34%, X2 10,174 p=0,001), significant increase of aortic regurgitation at 1 year (28,2% vs. 4,34%, X2 5,42 p=0,017) and last follow-up (30,4% vs. 4,34%, X2 6,133 p=0,011). Non-paced procedures were associated with a higher risk of reintervention (23,9% vs. 4,34%, X2 4,086 p=0,039).
There was no difference in arrhythmia inducibility due to ventricular pacing (13,4% vs. 8,69%, X2 0,87 p=0,7).
CONCLUSION:
Rapid ventricular pacing for aortic valvuloplasty does not increase the risk of arrhythmias, simplifies the procedure and is associated with lower rates of reintervention possibly by diminishing the number of balloon inflations needed.