The Effects of Trans Venous Cardiac Pacing on Coronary Microvascular Function and Hemodynamics

The Effects of Trans Venous Cardiac Pacing on Coronary Microvascular Function and Hemodynamics

The study will examine role of transvenous pacing on coronary microcirculation.

To study the role of transvenous pacing on the coronary microcirculation. This will be accomplished by gathering data from invasive Fractional Flow Reserve (FFR) and Coronary Flow Reserve (CFR) with and without ventricular pacing.

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