Exclusively cephalic venous access for cardiac resynchronisation: A prospective multi-centre evaluation

Area of Science:

• Cardiology
• Medical Devices
• Vascular Access

Background:

• Previous studies suggest cephalic venous access is viable for cardiac resynchronisation therapy (CRT).
• The suitability of this method for widespread clinical application requires further investigation.

Purpose of the Study:

• To evaluate the feasibility and safety of using exclusively cephalic venous access for all CRT device implants.
• To compare outcomes, duration, and complications with traditional methods.

Main Methods:

• A prospective study involving 19 operators (including 11 trainees) across three centers over 8 years.
• Collected data on access route, outcome, duration, and complications for 1091 attempted CRT implants using cephalic access.
• Compared results with 105 CRT implants performed by experienced operators using non-cephalic methods.

Main Results:

• Successful CRT implantation using cephalic access alone in 73.4% of cases (801/1091).
• Cephalic access was used for 78.8% of all implanted leads (2468/3132).
• Fewer complications (69/1091 vs 12/105) and no pneumothoraces were observed with cephalic implants. Shorter procedure and fluoroscopy times were noted.

Conclusions:

• Cardiac resynchronisation therapy devices can be successfully implanted in a substantial majority of patients using exclusively cephalic venous access.
• This approach offers a safe and efficient alternative for CRT device implantation.