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Iliac vein approach to permanent pacemaker implantation
1Memorial Heart Institute, Memorial Medical Center, Long Beach, California 90801-1428.
Pacing and Clinical Electrophysiology : PACE
|July 1, 1989
Summary
This study explored the iliac vein approach for permanent pacemaker implantation. While simple, lead dislodgement, particularly in atrial pacing, remains a significant concern.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Procedures
Background:
- Permanent pacemaker implantation is a common procedure.
- Traditional pectoral implantation sites have limitations.
- An alternative iliac vein approach has been utilized.
Purpose of the Study:
- To evaluate the efficacy and safety of the iliac vein approach for permanent pacemaker implantation.
- To present this method as an alternative to pectoral implantation.
Main Methods:
- A retrospective analysis of 95 permanent pacemaker implants in 90 patients via an iliac vein approach.
- Incision superior to the inguinal ligament for iliac vein cannulation.
- Pulse generator placement in the subcutaneous tissue of the abdomen.
Main Results:
- Overall, 28 atrial, 53 ventricular, and 14 dual-chamber pacemaker implants were performed.
- Atrial lead displacement occurred in 21% (9/28) requiring repositioning.
- Ventricular lead dislodgement occurred in 7% (5/53) requiring revision.
- Lead dislodgement, especially atrial, is a significant weakness.
Conclusions:
- The iliac vein approach for permanent pacemaker implantation is technically simple.
- Lead dislodgement, particularly atrial, diminishes the utility of this method.
- This approach offers an alternative to conventional pectoral implantation sites.