Description
William H. Sauer, MD, FHRS, CCDS, of Brigham and Women's Hospital is joined by guests Sunil Kapur, MD, of Brigham and Women's Hospital, and Joshua M. Cooper, MD, FHRS, of Temple University Health System to discuss Intra-Pocket Ultrasound-Guided Axillary Vein Puncture vs. Cephalic Vein Cutdown for Cardiac Electronic Device Implantation: The ACCESS Trial. Intra-pocket ultrasound-guided axillary vein puncture (IPUS-AVP) for venous access in implantation of transvenous cardiac implantable electronic devices (CIED) is uncommon due to the lack of clinical evidence supporting this technique. This study investigated the efficacy and early complications of IPUS-AVP compared to the standard method using cephalic vein cutdown (CVC) for CIED implantation. IPUS-AVP is superior to CVC in terms of success rate, time to venous access, procedure duration, and radiation exposure. Complication rates were similar between the two groups. Intra-pocket ultrasound-guided axillary vein puncture should be a recommended venous access technique for CIED implantation.
Learning Objectives
- To understand the differences in venous access techniques for intravascular lead implantation.
Article Authors and Podcast Contributors
Article Authors
Paul Charles, Geoffroy Ditac, Mathieu Montoy, Thibaut Thenard, Pierre-Yves Courand, Pierre Lantelme, Brahim Harbaoui, Samir Fareh
Podcast Contributors
William H. Sauer, MD, FHRS, CCDS, of Brigham and Women's Hospital
Sunil Kapur, MD, of Brigham and Women's Hospital
Joshua M. Cooper, MD, FHRS, of Temple University Health System
Disclosure Policy
ACE Disclosure Policy
The Heart Rhythm Society is committed to the provision of Accredited Continuing Education (formerly known as Continuing Medical Education (CME)) that is balanced, objective, and evidence based. HRS adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME) which require that those individuals in a position to control the content of an educational activity (including, but not limited to, planners, faculty, authors, committee members, content reviewers, editors, and staff) disclose all financial relationships with an ACCME-defined ineligible company* within the 24 months prior to the disclosure.
Any individual who refuses to disclose financial relationships is disqualified from participating in HRS ACE-certified activities. Owners and employees of ACCME-defined ineligible companies may have no role in the planning or implementation of ACE activities without a special written exemption from the HRS Chief Learning Officer that will be granted only in specific circumstances that meet ACCME requirements.
ACCME Definition:
*An ineligible company is one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Examples of such organizations include:
- Advertising, marketing, or communication firms whose clients are ineligible companies
- Bio-medical startups that have begun a governmental regulatory approval process
- Compounding pharmacies that manufacture proprietary compounds
- Device manufacturers or distributors
- Diagnostic labs that sell proprietary products
- Growers, distributors, manufacturers or sellers of medical foods and dietary supplements
- Manufacturers of health-related wearable products
- Pharmaceutical companies or distributors
- Pharmacy benefit managers
- Reagent manufacturers or sellers
All relevant financial relationships have been mitigated.Host Disclosure(s):
W. Sauer: Honoraria/Speaking/Consulting Fee: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific; Research (Contracted Grants for PIs Named Investigators Only): Medtronic
Contributor Disclosure(s):
S. Kapur: Honoraria/Speaking/Consulting Fee: Medtronic, Novartis, Abbott, Biotronik
J. Cooper: Honoraria/Speaking/Consulting Fee: Medtronic, Biosense Webster, Inc., Abbott, Boston Scientific, Medical Device Business Services, Zoll Medical Company
Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):
J. Glenn: No relevant financial relationships with ineligible companies to disclose.
S. Sailor: No relevant financial relationships with ineligible companies to disclose.