{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:20:35Z","timestamp":1791490835744,"version":"4.3.4"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,18]],"date-time":"2021-07-18T00:00:00Z","timestamp":1626566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Permanent\u00a0cardiac implantable electronic devices (CIEDs)\u00a0are traditionally implanted with the assistance of fluoroscopy. While clinically effective, this\u00a0technique\u00a0exposes both patients and providers to radiation which is\u00a0associated with adverse health effects\u00a0and represents an occupational hazard. In this study, we investigate the safety and feasibility of permanent CIED placement under the guidance of\u00a0transthoracic echocardiography (TTE).\u00a0There is also increasing interest in use of non\u2010fluoroscopic options for noninvasive cardiac electrophysiologic procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifteen patients consecutively consented for initial implant of CIEDs,\u00a0specifically dual chamber pacemakers (DCPM) and dual chamber implantable cardioverter defibrillators (DCICDs).\u00a0Patients were excluded if they had previous implants, abandoned leads, or anatomic anomalies including congenital and\u00a0known\u00a0persistent left superior vena cava\u00a0(PLSVC).\u00a0We used TTE to guide and implant atrial and ventricular leads.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven patients received DCPMs and four patients received DCICDs. The procedure duration was 49.3\u00a0min for DCICD and 52.3\u00a0min for DCPM, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.807. The average number of right atrial lead attempts was 1.6 for DCPMs and 1.8 for DCICD, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.860. The average number of right ventricular lead attempts for DCPMs was 2.2 and 1.0 attempt for DCICDs, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.044. There were no complications at 90\u2010day follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrate the feasibility of TTE\u2010guided DCPM\/DCICD implantation\u00a0without\u00a0use of fluoroscopy. We present this method as a safe alternative for permanent CIED placement that may reduce risk of radiation exposure and cost while maintaining safety and efficacy. No operators wore lead aprons during the procedure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14296","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T01:45:51Z","timestamp":1623635151000},"page":"1365-1370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Feasibility study for echocardiography\u2010guided lead insertion for permanent cardiac implantable electronic devices"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3736-9971","authenticated-orcid":false,"given":"Omolade O.","family":"Sogade","sequence":"first","affiliation":[{"name":"Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0952-9256","authenticated-orcid":false,"given":"Rieta N.","family":"Aben","sequence":"additional","affiliation":[{"name":"Georgia Arrhythmia Consultants  Macon Georgia USA"},{"name":"Department of Medicine Mercer University School of Medicine  Macon Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6132-6926","authenticated-orcid":false,"given":"Harry","family":"Eyituoyo","sequence":"additional","affiliation":[{"name":"Georgia Arrhythmia Consultants  Macon Georgia USA"},{"name":"Department of Medicine Mercer University School of Medicine  Macon Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkechi C.","family":"Arinze","sequence":"additional","affiliation":[{"name":"Georgia Arrhythmia Consultants  Macon Georgia USA"},{"name":"Department of Medicine Mercer University School of Medicine  Macon Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7262-0987","authenticated-orcid":false,"given":"Felix O.","family":"Sogade","sequence":"additional","affiliation":[{"name":"Georgia Arrhythmia Consultants  Macon Georgia USA"},{"name":"Department of Medicine Mercer University School of Medicine  Macon Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2011.03150.x"},{"key":"e_1_2_10_3_1","first-page":"1044","article-title":"Risks related to fluoroscopy radiation associated with electrophysiology procedures","volume":"7","author":"Picano E","year":"2014","journal-title":"J Atr 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Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.14296","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pace.14296","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.14296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T17:05:47Z","timestamp":1693328747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.14296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,18]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/pace.14296"],"URL":"https:\/\/doi.org\/10.1111\/pace.14296","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,18]]},"assertion":[{"value":"2020-10-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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