Ultrasound-guided vascular access for CIED implantation: A step-by-step guide

Vascular access is required for most cardiac electrophysiology procedures. Over the past 2 decades, ultrasound guidance has increased in utilization as the primary method for assisting operators in gaining access to cardiac implantable electronic device (CIED) implantation.

Ultrasound guidance using a technique that includes both short-axis and long-axis views combined with a twisting needle motion after maximal tenting provides an extremely safe and reproducible technique for vascular access for all CIED procedures.

In this manuscript and accompanying videos, a step-by-step guide is explained for optimal ultrasound-guided visualization and needle maneuver technique to maximize safety and efficiency for vascular access in all CIED procedures.