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The Jugular Approach for Leadless Pacemaker Implantation
Session:
Sessão de Posters 29 - Pacing sem elétrodos e inovação em dispositivos
Speaker:
Fernando Nascimento Ferreira
Congress:
CPC 2026
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.1 Antibradycardia Pacing
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Fernando Ferreira; Pedro Silva Cunha; Sofia Jacinto; Margarida Figueiredo; Manuel Brás; Helder Santos; Guilherme Portugal; Bruno Valente; Ana Lousinha; Paulo Osório; Rui Cruz Ferreira; Mário Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Introduction: </span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Leadless pacemakers have emerged as a valuable alternative to conventional transvenous pacing systems, particularly in patients with higher infectious risk, limited venous access or severe chronic renal disease. The femoral vein is the stablished traditional access, but the approach through internal jugular vein has been proposed as an alternative to simplify the device delivery, reduce procedural time and allow for earlier mobilization. However, data on the efficacy and safety of the jugular approach remain limited. <strong>Objective:</strong> to evaluate the initial experience of leadless pacemaker implantation via right jugular access.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods:</span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> A retrospective cohort study including adult patients who underwent leadless pacemaker implantation through the jugular vein between January and October 2025 at a tertiary centre. Baseline clinical characteristics and procedural variables were collected. </span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Univariate analysis, including chi-square and </span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Mann–Whitney U were used in between-group comparisons (jugular vs. femoral access). A p-value < 0.05 was considered statistically significant.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results:</span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> A total of 13 consecutive patients (mean age 80.7 ± 6.3 years; 38% female) underwent jugular leadless pacemaker implantation. The main indications were previous device infection (31%) and severe chronic kidney disease or dialysis (46%). The majority of the procedures were performed in outpatients (86%) and in patients with atrial fibrillation (77%). Implantation success was achieved in all patients. At implantation, mean sensing amplitude was 7.8 ± 2.5 mV, impedance 749 ± 142 Ω, and threshold 0.5 V (0.25–2.0). When compared with the femoral approach series of our centre (n=72), the jugular approach was associated with shorter fluoroscopy time (3.5 vs 5.4 min, <em>p</em> = 0.025), shorter total procedure time (51.7 ± 6.9 vs 59.3 ± 21.9 min, <em>p</em> = 0.045), and shorter hospitalization duration (<em>p</em> = 0.026). No major procedural complications were observed. <strong>Conclusion:</strong> Leadless pacemaker implantation via jugular access is safe and feasible with high success and adequate electrical performance. Compared with the usual femoral approach, appeared to be associated with shorter fluoroscopy and procedure times, as well as reduced hospitalization length. Larger prospective studies are needed to confirm these observations.</span></span></span></span></span></p>
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