1. Placement of a dual-chamberpacemaker.Using a standard technique, theleft infraclavicular subcutaneous pacemaker pocket was createdwith sharp and blunt dissection. The 2j-tipped guidewires were advanced through a left subclavian veinusing standard left subclavian venotomyunder fluoroscopic guidance. The peel-away sheaths andintroducers were advanced over the guidewires, and theguidewires were removed. The pacemaker leadswere advanced under fluoroscopic and electrophysiologic guidance intothe right ventricular apex andrightatrial appendage. The pacemaker leads were seen to function adequately in vivoand were suturedinplace with0 silk. The leads were connected to the pulse generator, which was deliveredinto the woundin the usual fashion;2-0 Vicryl suture was used to close the deep tissue layer and a 4-0 runningsubcuticular suture was used to close theskin. There were no complications of theprocedure.CPTCode:
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