Use of the Contralateral Subclavian Vein for Placement of Atrial Electrodes in Chronically VVI Paced Patients

Two patients with documented pacemaker syndrome were referred for AV sequential pacing and were found to have inaccessible venous systems on the side of their original transvenous pacemaker placement. The confralateral subclavian vein was subsequently catheterized with an atrial electrode using the sheathset technique, Then the proximal aspecf of the atrial endocardial lead was tunneled to the original pacemaker pocket, Once accomplished, both (atrial and ventricular) leads were connected to an AV sequentiat pulse generafor. The united puise generalorand lead were reinserted in the original pacemaker pocket.