Transvenous cardiac pacing. Experience of a percutaneous supraclavicular approach

A detailed description is given of a technique for the introduction of cardiac pacing catheters using a percutaneous supraclavicular route through the subclavian vein. In 91 attempts there was only one failure and the frequency of complications was low. Surface landmarks for the procedure were easy to define precisely, and stable pacing could usually be established rapidly without distress to the patient or subsequent immobilization of any limb. It is suggested that operators with little experience of cardiac catheterization might find this approach valuable in the emergency pacing of acute heart block. Subclavian venepuncture does not appear to be as hazardous as has previously been suggested.