The Effects of Trans Venous Cardiac Pacing on Coronary Microvascular Function and Hemodynamics
Coronary Microvascular Disease, Cardiac Pacemaker Syndrome
About this trial
This is an interventional basic science trial for Coronary Microvascular Disease focused on measuring coronary microvascular dysfunction
Eligibility Criteria
Inclusion Criteria:
All patients 19 years of age or older with clinical evidence of coronary ischemia undergoing coronary angiogram, and who have a pacemaker.
Exclusion Criteria:
- Acute ST segment myocardial infarction
- Known sensitivity or contraindication to the agents planned for administration during coronary angiography
- Pacemaker dependent patients
- Pregnancy
- Hypotension (a systolic blood pressure lower than 90mmHg) that would preclude the administration of adenosine
- Severe renal dysfunction, defined as a estimated glomerular filtration (eGFR) less than 30ml/min, confirmed by recent testing
- Study subject has any underlying disorder that, in the opinion of the investigator, precludes them from giving informed consent at the time of enrollment
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Other
Other
Right ventricular Pacemaker
Biventricular Pacemaker
Patients with right ventricular pacing and evidence of coronary ischemia who have evidence of coronary ischemia who are to undergo coronary angiogram.When an intermediate stenosis (40-80%) has been identified angiographically, this lesion will undergo further hemodynamic assessment, All data including resting flow, FFR, CFR, vital signs, arrhythmias and patient symptoms will be recorded twice: once when the pacemaker is programmed to pace, and once when the PPM is reprogrammed such that the pacemaker is no longer pacing.
Patients with Biventricular pacing and evidence of coronary ischemia who have evidence of coronary ischemia who are to undergo coronary angiogram.When an intermediate stenosis (40-80%) has been identified angiographically, this lesion will undergo further hemodynamic assessment, All data including resting flow, FFR, CFR, vital signs, arrhythmias and patient symptoms will be recorded twice: once when the pacemaker is programmed to pace, and once when the PPM is reprogrammed such that the pacemaker is no longer pacing.