Modified cephalic venous approach facilitates permanent pacing leads implantation / 中国介入心脏病学杂志

ABSTRACT

Objective To investigate the feasibility of exposing cephalic vein with horizontal incision on the chest and the successful rate of implanting pacing leads using guide wire and split sheath. Methods Right cephalic vein was separated with horizontal incision on the right lateral upper part of chest in 220 patients with permanent pacing indication. The pacing lead was advanced through the cephalic vein directly or by using a guidewire and a split sheath if the direct approach was unsuccessful. The subclavian venous puncture through the incision was used finally to implant the endocardial lead when the cephalic approach failed. All pacemakers were placed in the subcutaneous package at the inner part of the incision. Results Cephalic vein was well exposed with horizontal incision. Additionally, it is safe and convenient to puncture the subclavian vein through this incision. The successful rate of implanting pacing leads directly through cephalic vein was only 71% with single lead and 58% with dual pacing leads, respectively. However, it increased to 94% with single lead and 88% ( P