title: Ultrasound-guided venous access for pacemakers and defibrillators.
abstract: BACKGROUND
  Ultrasound guidance is widely recommended to reduce the risk of complications during central venous catheter placement. However, ultrasound guidance is not commonly utilized for implanting leads for cardiac rhythm management devices.
  
  
  RESULTS
  We describe our technique of ultrasound-guided pacemaker implantation, including a novel pull-through technique that allows percutaneous guidewire insertion prior to the first incision. We review the literature and recent advances in ultrasound imaging technology that may facilitate the adoption of ultrasound guidance.
  
  
  CONCLUSIONS
  Ultrasound guidance provides a safe and rapid technique for extrathoracic subclavian or axillary venous lead placement.
authors.affiliation: University of California, Irvine Medical Center, California, USA. aseto@uci.edu
authors.forename: Arnold H
authors.initials: AH
authors.lastname: Seto
authors.forename: Aaron
authors.initials: A
authors.lastname: Jolly
authors.forename: Jonathan
authors.initials: J
authors.lastname: Salcedo
mesh_terms: D001367:Axillary Vein / Q000000981:diagnostic imaging*; D002304:Cardiac Pacing, Artificial; D002405:Catheterization, Central Venous / Q000379:methods*; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation*; D006801:Humans; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000379:methods*; D011677:Punctures; D013350:Subclavian Vein / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional