Permanent Transvenous Cardiac Pacing Via the Left Cephalic Vein

Upper Body Venous Access for Transvenous Lead Placement—Review of Existent Techniques

“…Cutdown exposes a vein to direct vision, and is mostly used when the target vein is relatively superficial and exposing it does not require much dissection. The two veins in the upper body which fit this criterion are the cephalic vein 8 and the external jugular vein 10,37 (Fig. 1).…”

“…Almost all the major veins outside the thoracic cavity have been explored by clinicians as potential entry points for obtaining central venous access. For transvenous lead placement, the internal jugular vein, 9,13,14 the external jugular vein 10,38 the subclavian vein, 12,[39][40][41][42][43] the axillary vein, 18,22,25 the cephalic vein, 8,[44][45][46][47][48][49] the femoral vein, 50 and the iliac vein [51][52][53] have all been used. Of the many different options, the only two that are routinely used in clinical practice are the subclavian vein (and its direct continuation, the axillary vein) and the cephalic vein.…”

“…Both PPMs and ICDs were largely implanted by surgeons when the technologies were first developed, but are increasingly implanted by cardiologists 6,7 . Over time, many different techniques for obtaining venous access for transvenous lead placement have been developed 8–25 . Concurrently, other specialists (notably radiologists, 26,27 anesthesiologists, 28–32 intensivists, 33 nephrologists, 34,35 and surgeons 36,37 ) have all developed their own techniques of obtaining central venous access for their own needs.…”

“…6,7 Over time, many different techniques for obtaining venous access for transvenous lead placement have been developed. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Concurrently, other specialists (notably radiologists, 26,27 anesthesiologists, [28][29][30][31][32] intensivists, 33 nephrologists, 34,35 and surgeons 36,37 ) have all developed their own techniques of obtaining central venous access for their own needs. Theoretically, these techniques can also be used in transvenous lead placement.…”

Implantable Transvenous Cardiac Pacemakers: Indications, Complications and Management*

“…It is approached through an oblique incision in the deltopectoral groove (12). The electrode is thus protected from neck and shoulder-girdle movements.…”