Cephalic veins cutdown technique

Fig. 4.8 Cephalic vein cutdown technique. The cephalic vein is isolated and tied off distally. (From Belott PH, Reynolds DW. Permanent pacemaker implantation. In EUenbogen KA, Kay N, WiUcoff BL, eds. Clinical cardiac pacing. Philadelphia WB Saunders, 1995, with permission.)...

Cutdown with cephalic vein guidewire (Ong-Barold technique)... 

Dual-chambered pacing calls for the introduction of an atrial and ventricular electrode. The cutdown technique is less suited for this approach because all too often the cephalic vein can hardly acconunodate one electrode, and even less two. The percutaneous approach appears ideally suited for dual-chambered pacing as there is potential for unlimited access to the venous circulation. Various options for dual-chambered pacing venous access are listed in Table 4.10. There are four percutaneous approaches for dual-chambered pacing. 

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