A comparison of lead placement through the subclavian vein technique with fluoroscopy-guided axillary vein technique for permanent pacemaker insertion

The Canadian Journal of Cardiology
Gautam SharmaVinay K Bahl

Abstract

The intrathoracic subclavian venous technique for pacemaker implantation may be associated with serious complications. We describe an alternative technique for obtaining venous access for pacemaker implantation through axillary vein under fluoroscopic guidance and compare it with the conventional, subclavian approach. We conducted a single-centre, prospective, nonrandomized study. All adult patients with indication for permanent pacing who consented were recruited during a 3-year period. To access the axillary vein, we used the alternative technique with a new fluoroscopic landmark. The subclavian access was obtained as per the usual approach. We studied 478 lead placements during 3 years; 315 lead placements through axillary venous technique (group 1) were compared with 163 lead placements through subclavian venous technique (group 2). Both routes had a high and comparable success rate, 98.09% in group 1 and 96.93% in group 2. The axillary approach was successful at the first attempt in 194 punctures (61.6%), as vs 60 in group 2 (36.8%) P < 0.0001. The average number of attempts in group 1 was 2.06 per patient and 2.56 in group 2 (P < 0.001). There were 3 (2.94%) pneumothoraxes in group 2 and none in group 1. During a mean fol...Continue Reading

References

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Citations

May 23, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Sergio Castrejón-CastrejónJosé Luis Merino
May 15, 2013·Pacing and Clinical Electrophysiology : PACE·Meng JiangBen He
Jan 11, 2016·Journal of Cardiovascular Electrophysiology·Eduardo FrancoJavier Moreno
Jun 28, 2015·The Canadian Journal of Cardiology·Guram ImnadzeWolfgang Kranig
May 10, 2015·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Federico MiglioreEmanuele Bertaglia
Mar 4, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Ki-Hun KimKee-Joon Choi
May 15, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Felix Yang, Guy Kulbak
Nov 5, 2013·The Canadian Journal of Cardiology·Ratika ParkashUNKNOWN Canadian Cardiovascular Society
May 28, 2016·Pacing and Clinical Electrophysiology : PACE·John KotterClaude S Elayi
Jan 9, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Fabien SquaraEmile Ferrari
Dec 6, 2018·Pacing and Clinical Electrophysiology : PACE·Bradley C ClarkRobert H Pass
Jan 18, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Mattia LiccardoCarmine Ciardiello
Sep 25, 2014·Journal of Cardiovascular Medicine·Federico MiglioreEmanuele Bertaglia
Feb 18, 2016·Pacing and Clinical Electrophysiology : PACE·Abdullah EsmaielVartan Mardigyan
Jun 24, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Francesco De SensiUgo Limbruno

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