Show Notes
Is it time to move beyond RV pacing and rethink the future of TAVR procedures with dedicated LV pacing strategies? In this episode of BackTable Cardiology, host Stephanie Younes talks with Dr. Jeff Southard, interventional cardiologist at UC Davis, about the evolution of left ventricular (LV) pacing and its impact on TAVR workflow. They discuss the limitations of earlier off-the-shelf LV pacing methods, the reasons for relying on RV pacing in the past, and how a shift to dedicated LV pacing wires is changing daily practice for both balloon-expandable and self-expanding valves.
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This podcast is supported by
Merit Medicalhttps://www.merit.com/product/solopace-fusion-system/
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Timestamps
00:00 - Introduction02:27 - Early LV Pacing Skepticism06:08 - Backup Strategy and Capture Test08:02 - Step by Step TAVR Workflow12:32 - Reasons for Slow Adoption14:04 - Wire Design and Iterations15:55 - Sheath Support in Tough Anatomy16:57 - Avoiding Aortic Scrape Risks18:08 - Staffing and Table Roles20:51 - Beyond TAVR Use21:58 - Device Design and Reliability24:16 - EZ-TAVI Data Breakdown27:28 - Algorithms vs. RV Pacing29:17 - Purpose Built LV Pacing Wrap Up30:25 - Wrap Up and Credits
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More about this episode
Dr. Southard details how his team’s adoption of a dedicated LV pacing wire improved reliability, reduced the need for venous access, and helped eliminate RV pacing-wire complications. He explains how this approach has saved time, streamlined staffing by moving pacing control to the sterile table, and minimized procedural steps. The conversation covers patient selection, exceptions for those at higher risk of heart block, technical pearls, and recent data from the EZ-TAVI trial. They also highlight the clinical significance of multi-point LV endocardial contact and adaptive algorithms for maintaining capture during TAVR procedures.
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Resources
TAVR Trialhttps://pubmed.ncbi.nlm.nih.gov/31857014/
SoloPACEhttps://www.solopace.health/
Dr. Jeffrey Southard UC Davishttps://health.ucdavis.edu/medical-center/team/1170/jeffrey-southard---cardiology---cardiovascular-medicine---interventional-cardiology---internal-medicine-sacramento/
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