Outcomes of left ventricular pacing with a pre-shaped guidewire during transcatheter aortic valve implantation

Introduction and objectives: Rapid ventricular pacing is essential to ensure accurate valve deployment during transcatheter aortic valve implantation (TAVI).Although it is traditionally performed via right ventricular (RV) pacing using a temporary pacemaker, left ventricular (LV) pacing with pre-shaped guidewires has emerged as an effective alternative, associated with shorter procedural and fluoroscopy times.There are no data available on the use of the Abbott Circulo guidewire.The aim of this study was to evaluate its safety and efficacy profile for LV pacing during TAVI.Methods: This was a prospective, multicenter, observational study with patients undergoing transfemoral TAVI with LV pacing using the Circulo guidewire.The primary endpoint was pacing efficacy, defined as a reduction in systolic blood pressure < 60 mmHg.Secondary endpoints included the pacing threshold, crossover to RV pacing, and perioperative complications.Results: A total of 50 patients were enrolled from March through June 2025 (mean age, 80.56 ± 6.26 years; 62% women).Rapid LV pacing was successful in 100% of cases, with a mean pacing threshold of 7.00 ± 3.48 mV.A total of 3 patients required crossover to RV pacing due to atrioventricular block after balloon predilatation.The overall rate of complications was 14%, with rhythm disturbances being the most common adverse events.There were no complications associated with the use of the Circulo guidewire.Conclusions: LV pacing using the Circulo guidewire during TAVI is safe and effective, and avoids the routine use of temporary transvenous pacemakers.