P.2. Syncope, Pacemaker, CRT & ICD

Cephalic vein (CV) approach is preferable to subclavian vein when technically feasible. Aim of the study was to describe a technique to extend the use of CV for lead implantation. This technique was applied every time the lead didn't proceed through the CV. Methods After the isolation of the CV as usual a Terumo straight wire was advanced under fluoroscopy control through the subclavian vein up to the right atrium. Then an appropriate-size dilator and sheath with a peel-away system was slipped over the wire. In case of dual-chamber pacemaker the wire was kept in place for the second lead. Results All patients (Pts) (77±8 years) were implanted with tined bipolar atrial and ventricular leads. Our technique was applied in 64 pts (9% single-lead VDD, 55% dual-chamber and 36% single-chamber). No complications were reported in these pts neither in acute nor at follow-up (1 and 3 months). The subclavian approach was used only in 11% pts, when both the standard cephalic approach and this technique failed. Conclusion Our technique is feasible in the majority of patients and always safe.