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Innovation in Permanent Pacemaker's Implantation Technique: Trans-Axillary Approach.

Bakhtawar Shah1, Muhammad Amir Niaz2, Shahab Saidullah3

  • 1Division of Clinical Cardiac Electrophysiology, Department of Cardiology, Hayatabad Medical Complex, Peshawar, PAK.

Cureus
|May 17, 2021
PubMed
Summary

A new trans-axillary approach for permanent pacemaker (PPM) implantation offers significant advantages. This technique reduces implantation time and complications compared to conventional methods.

Keywords:
axillary veinerosionimplantationleadpermanent pacemakersvenogram

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Permanent pacemaker (PPM) implantation is a cornerstone of cardiology.
  • Technological advancements aim to enhance PPM effectiveness, longevity, and patient outcomes.
  • This study introduces a novel implantation technique to improve procedural efficiency and reduce complications.

Purpose of the Study:

  • To evaluate a new trans-axillary approach for permanent pacemaker implantation.
  • To compare the efficacy and safety of the trans-axillary technique against conventional methods.
  • To assess the potential for reducing complications and procedure time.

Main Methods:

  • The study involved 690 PPM implantations between January 2016 and February 2017.
  • A trans-axillary venous approach using the Seldinger technique was employed.
  • A subcutaneous pocket was created, and leads were secured followed by layered wound closure.

Main Results:

  • A total of 690 PPMs were implanted; 290 conventional and 380 via trans-axillary approach.
  • The mean implantation time for the trans-axillary approach was under 30 minutes.
  • Both immediate and delayed complications were minimal with the new technique.

Conclusions:

  • The trans-axillary approach demonstrates significant advantages over conventional PPM implantation.
  • This technique effectively reduces foreign material burden and wound tension.
  • Shorter implantation times and decreased device erosion risk are key benefits.