Implantation of Permanent Transvenous Pacemaker via Subclavian Vein

Abstract
• A favorable overall experience was found with permanent transvenous cardiac pacing using a direct venipuncture for entry into the subclavian vein. The method allows rapid and relatively atraumatic introduction of a variety of transvenous pacemaker electrodes. However, a fatal complication developed that was caused by unrecognized puncture of the left pulmonary artery in an elderly patient. This was the result of a technical error and emphasizes that experience in subclavian venipuncture is essential to avoid the complications of this approach. (Arch Surg 1982;117:1105-1107)