Journal Article

Permanent pacemaker implantation via the femoral vein: an alternative in cases with contraindications to the pectoral approach

G. Mathur, R. H. Stables, D. Heaven, A. Ingram and R. Sutton

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 3, issue 1, pages 56-59
Published in print January 2001 | ISSN: 1099-5129
Published online January 2001 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1053/eupc.2000.0135
Permanent pacemaker implantation via the femoral vein: an alternative in cases with contraindications to the pectoral approach

Show Summary Details

Preview

Background

This paper presents a consecutive series of permanent pacemakers (PPM) implanted via the femoral vein in patients with contraindications to pacing systems via the superior vena cava (SVC). The femoral vein approach is a less invasive and feasible alternative to epicardial lead placement.

Methods

Twenty-seven patients had femoral pacemakers inserted. Indications for femoral vein pacemaker insertion were: SVC/subclavian obstruction (12 patients, 44·4%), previous infection in SVC leads (four patients, 14·8%), mastectomy and/or radiotherapy to chest (four patients, 14·8%), multiple leads in SVC (two patients, 7·4%), recurrent erosion (two patients, 7·4%), abnormal anatomy (one patient, 3·7%), painful pacemaker pocket (one patient, 3·7%) and burns (one patient, 3·7%). Fifty-one leads, 25 atrial and 26 ventricular, were inserted. The majority of leads were active fixations (96% of atrial leads and 85% ventricular leads).

Results

During a mean follow-up of 36·5 months (range 0·9–116·5), six additional unplanned procedures were performed in four patients. Atrial lead displacement occurred in five leads (20%). There were no ventricular lead displacements. In two patients, box revision for pre-erosion was required. One patient had persistent pain at the site of abdominal pacemaker generator. Infection, thromboembolic events, thromophlebitis, evidence of lower limb venous occlusion and lead fracture did not occur.

Conclusion

Femoral vein PPM are a simple and feasible alternative in patients in whom the SVC approach is contraindicated.

Keywords: Permanent pacemaker; implantation; femoral approach

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.