Permanent Pacemaker Implantation via the Iliac Vein: An Alternative in 4 Cases with Contraindications to the Pectoral Approach

Koji Tsutsumi, Kenichi Hashizume, Naritaka Kimura, Shinichi Taguchi, Yoshito Inoue, Ichiro Kashima, Ryuichi Takahashi

Research output: Contribution to journalArticle

1 Citation (Scopus)


We report the outcome of the iliac vein approach for permanent pacemaker implantation in 4 patients in whom the conventional pectoral approach was not possible. The reasons for using the iliac vein approach were: recurrent lead infections at bilateral pectoral positions in 1 patient; superior vena cava obstruction following cardiac surgery in 2 patients; and a postoperative dermal scar due to right radical mastectomy secondary to a persistent left superior vena cava with absence of the innominate vein in 1 patient. This technique was safe and effective during the mean follow-up period of 24.3 months. At the latest follow-up, no patients showed signs of electrophysiological abnormalities. No short- or long-term complications were seen. Conclusions: The iliac vein approach is a less invasive and more feasible alternative without any complications for patients in whom the pectoral approach cannot be used.

Original languageEnglish
Pages (from-to)55-61
Number of pages7
JournalJournal of Arrhythmia
Issue number1
Publication statusPublished - 2010 Jan 1
Externally publishedYes



  • Iliac vein approach
  • Pacemaker implantation
  • Pectoral approach

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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