Transjugular Seldinger approach for permanent pacemaker implantation in octogenarian with inaccessible upper limbs venous system

• Main Authors: Alexander Edo Tondas, Rido Mulawarman, Monica Trifitriana, Savero Evan Abisha, Raymond Pranata
• Format: Article
• Language: English
• Published: Wiley 2020-02-01
• Series: Journal of Arrhythmia
• Subjects: internal jugular vein; permanent pacemaker; Seldinger technique; upper limb deep vein thrombosis
• Online Access: https://doi.org/10.1002/joa3.12287
• ISSN: 1880-4276; 1883-2148

Abstract In up to 13.7% of device implants, lead entry through the cephalic, axillary, or subclavian veins might be unfeasible. Transjugular permanent pacemaker (PPM) implantation may be considered as a bailout strategy in the difficult anatomy of conventional veins, before resorting to epicardial pacing lead, which requires general anesthesia and thoracotomy. We described a case report of a single chamber PPM implantation in an 83‐year‐old man using transjugular Seldinger approach without surgical cut down of the internal jugular vein, due to spasm, stenosis, and thrombosis of the upper limbs venous systems. Acceptable lead impedance and threshold were maintained during 2 months follow‐up.