Ultrasound guidance, including a novel pull-through technique, offers a safe and rapid method for venous access during cardiac rhythm management device implantation.
May support ultrasound-guided extrathoracic access; leaves open prospective trials before practice change.
INTRODUCTION: Ultrasound guidance is widely recommended to reduce the risk of complications during central venous catheter placement. However, ultrasound guidance is not commonly utilized for implanting leads for cardiac rhythm management devices. METHODS AND RESULTS: We describe our technique of ultrasound-guided pacemaker implantation, including a novel pull-through technique that allows percutaneous guidewire insertion prior to the first incision. We review the literature and recent advances in ultrasound imaging technology that may facilitate the adoption of ultrasound guidance. CONCLUSIONS: Ultrasound guidance provides a safe and rapid technique for extrathoracic subclavian or axillary venous lead placement.
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Seto et al. (2012) studied this question.
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