Use of the Subclavian Vein by Percutaneous Puncture for Permanent Cardiac Pacing

One hundred and fifty patients, 85 males and 65 females with a mean age of sixty-six years (range thirty-five to eighty-five years) were paced permanently by use of the subclavian venipuncture technique. The indication for pacing was documented high-grade A-V block (80 patients), sick sinus syndrome (60 pa tients) and carotid hypertensitivity with recurrent syncope (10 patients). In 142 patients multiprogrammable VVI pacemakers and in 8 DDD pacemakers were implanted. The procedure lasted from twenty to fifty-five minutes (mean thirty minutes). Apart from a partial dislodging of the electrode tip in 1 patient, which resulted in intermittent exit block and was corrected by increasing the pulse width of the generator current, no other early complication was observed. The patients have been followed up from three to twenty-six months (mean eleven months). One patient has had the wire repositioned deeper in the subcutaneous tissue owing to imminent skin erosion. No other late complication has been noticed.