Placement of a Dual-Chamber Pacemaker

Short Answer

Placement of a dual-chamber pacemaker.
Using a standard technique, the left infraclavicular subcutaneous pacemaker pocket was created with sharp and blunt dissection. The 2 j-tipped guidewires were advanced through a left subclavian vein using standard left subclavian venotomy under fluoroscopic guidance. The peel-away sheaths and introducers were advanced over the guidewires, and the guidewires were removed. The pacemaker leads were advanced under fluoroscopic guidance into the right ventricular apex and right atrial appendage. The pacemaker leads were seen to function adequately in vivo and were sutured in place with 0 silk. The leads were connected to the pulse generator, which was delivered into the wound in the usual fashion; 2-0 Vicryl suture was used to close the deep tissue layer and a 4-0 running subcuticular suture was used to close the skin. There were no complications of the procedure. Code the pacemaker placement only.
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