Internal jugular veins pacing approaches

Venous access can be obtained by several approaches. The internal jugular veins, subclavian veins, and femoral veins are aU potential sites for introduction of the pacing catheter into the right heart (Table 7.2). The median basilic veins and basilic veins can also be used, but these sites are associated with a very high incidence of catheter dislodgment (because of arm motion) and are rarely, if ever, used today. 

In certain sitnations the internal jugular or subclavian veins may be inaccessible or the patient may have uncorrectable thrombocytopenia or coagulopathy, which necessitates access to the central venous system by the femoral vein. When using this approach for temporary pacing, fluoroscopy is required for pacing catheter placement. In addition to the need for fluoroscopy, other disadvantages include patient comfort (because the leg cannot be bent at the hip), increased risk of infection, and poor catheter stability. 

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