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Updated: Apr 25, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Endocardial left ventricular lead placement from the left subclavian vein approach
Naiara Calvo1, Hugo Arguedas1, Juan Pablo Canepa1
1Arrhythmia Unit, Department of Cardiology and Cardiac Surgery, University Clinic of Navarra and School of Medicine, University of Navarra, Av Pio XII, 36, 31008 Pamplona, Spain.
Aims:
In up to 10-15% of cases, the traditional epicardial approach for left ventricular (LV) lead placement is not feasible and surgical implantation is considered the alternative. We present the implantation of a transseptal LV lead through a left subclavian access.
Methods And Results:
Through the left subclavian vein access and using a system which includes a guiding catheter, a puncture screw catheter and a puncture stylet, access to the LV was achieved and the LV stimulation lead was successfully implanted.
Conclusion:
We describe the implantation of a transseptal LV stimulation lead through a left subclavian access.
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