Safety of Percutaneous Right Coronary Intervention without Temporary Pacemaker: Prospective Study

Lee, Sung Yun; Gwon, Hyeon Cheol; Kim, Hyun Jung; Jeong, Jin Ok; Ahn, Kyung Ju; Lee, Sang Cheol; Cho, Wook Hyun; Park, Seung Woo; Kim, June Soo; Kim, Duk Kyung; Lee, Sang Hoon; Hong, Kyung Pyo; Park, Jeong Euy; Seo, Jeong Don; Lee, Won Ro

Abstract

BACKGROUND: The prophylactic use of temporary pacemaker during coronary intervention has been markedly decreased since 1980's. There is, however, few systematic report focusing on right coronary intervention in which temporary pacemaker would be most beneficial. Moreover, there has been marked development in coronary intervention recent years that risk and benefit of prophylactic pacemaker should be reconsidered. METHOD: We performed right coronary artery intervention without prophylactic use of temporary pacemaker in 100 successive patients in Samsung Medical Center. Patients with previous AV block and rotational atherectomy cases were excluded. The incidence of all complications and changes of blood pressure as well as heart rate during coronary intervention were examined prospectively.
RESULTS
The lesion type was B2 or C in 52% and intracoronary thrombus was found in 18% of patients. Nevertheless, there was neither life threatening bradycardia nor new onset arrhythmia in any patient during right coronary intervention.
CONCLUSION
These data suggest that omission of prophylactic use of temporary pacemaker may be safe in right coronary intervention only if excluding previous patients with high degree atrioventricular block and rotational atherectomy cases. This approach may reduce procedure time and cost as well as pacemaker-associated complications.