The Electrical Management of Cardiac Rhythm Disorders, Bradycardia, Slide Presentation 02 Lead Technology
Venous Access site The implanting physician must know the acute and chronic complications associated with the various access sites. The physician should also be capable of accessing any and all of these sites. If the physician only knows one technique, that physician should not be doing implants. The recommended access site is the cephalic vein and if this is absent or inadequate, next is the axillary vein. The axillary vein is also called the extrathoracic subclavian vein. It is a continuation of the subclavian vein once it has crossed over the first rib. While venipuncture of the subclavian vein remains the most commonly used approach, it carries with it the highest incidence of acute and chronic complications. The external and internal jugular veins are rarely used today. When there is Superior Vena Cava syndrome or no venous access from above and the implanting physician still wants to use endocardial leads, extra-long (100 cm) leads can be inserted via the femoral vein with the pocket located in the lower abdomen. These should be active fixation. Slide Series: X-Ray-99.ppt
Operator explaining before implantation
Informed consent OK
Family (Adult ) company with the patient
Sign permit for extra fee ,such as MRI Lead and
1. Blood tests to evaluate the blood clotting
( PT/APTT),CBC/DC and blood chemical
2. To stop taking some of medications before
3. Do not eat or drink after midnight the day of the
4. To set up intravenous fluids.
5. Remove all make up ,nail polish, jewelry,
watches ,artificial teeth and valuables, etc.
6. Skin preparing: Using 75% Clear the operation site
and then cover with a gauze.
7. Shaving the groins for TPM in case.
Implant Procedure Special for ICD
• Make sure IV line fluency and BP/SpO2
• Sedation given and con’s
• Be prepared to deliver RESCUE shock if ICD therapy is
unsuccessful ， external defibrillator stand by.
• Check IEGM for appropriate sensing and detection
• After therapy- Review delivered energies, charge time,
• Allow for patient recovery between tests- Suggested time 3 to