A new method for implanting pacemaker lead by puncturing cephalic vein / 第二军医大学学报

ABSTRACT

Objective: To introduce a new method for implanting pacemaker leads by puncturing the cephalic vein. Methods: Twenty-five patients who needed implantation of dual-chamber pacemakers or cardiac resynchronization therapy (CRT) were included in the present study. A guide wire and an introducer sheath were inserted successively after puncturing the cephalic vein. Another 1 or 2 guide wires were inserted into the introducer sheath and the introducer sheath was drawn back. Then 2 or 3 peel-away introducer sheaths were separately inserted via each guide wire, and the pacemaker leads were inserted into blood vessels and advanced into the heart. Results: Two or 3 peel-away introducer sheaths were successfully inserted into the blood vessels in 22 of the 25 patients, with no complications such as hematoma, pneumothorax, or subclavian artery puncture. We failed to isolate the cephalic veins in the other 3 patients and the patients were successfully converted to subclavian vein puncture. Conclusion: Our new method avoids the severe complications of traditional subelavian puncture. Compared with cephalic veins incision, our new method makes it easier and accurate for the pacemaker leads manipulation. But the cephalic veins are sometimes difficult to isolate.