Hbutler10
Contributor
Description of procedure: The patient was taken to the operating room and placed in supine position on the operating table. The patient was prepped and draped in a sterile fashion. The skin beneath the right clavicle was infiltrated with 1% lidocaine without epinephrine. An introducer needle was inserted into the right subclavian vein. A guidewire was inserted into the vein through the needle and directed down the superior vena cava under fluoroscopic visualization. The introducer needle was withdrawn. A dilator and introducer sheath were inserted into the right subclavian vein over the guidewire and guidewire and dilator withdrawn. The transvenous pacemaker was inserted via the introducer sheath and directed down the superior vena cava into the right atrium across the tricuspid valve into the right ventricle. There is good anatomic placement of the lead. The patient was noted to have no loss of capture at 1 mA. The lead was secured at this position. The introducer sheath was sutured to the chest wall with a 3-0 silk suture. Incision was cleaned and a sterile dressing applied.