{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T18:44:05Z","timestamp":1772217845733,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Many techniques exist for venous access (VA) during cardiac implantable electronic device (CIED) implantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to evaluate the learning curve with ultrasound (US) guided axillary vein access (USAA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010center prospective randomized controlled trial of patients undergoing CIED implantation. Patients were randomized in a 2:1 fashion to USAA versus conventional VA techniques. The primary outcomes were the success rates, VA times and 30\u2010day complication rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 100 patients (age 68\u00a0\u00b1\u00a014 years, BMI 27\u00a0\u00b1\u00a04\u00a0kg\/m<jats:sup>2<\/jats:sup>). USAA was successful in 66\/70 implants (94%). Initial attempts at conventional VA included 47% axillary (<jats:italic>n<\/jats:italic>\u00a0=\u00a014), 30% (<jats:italic>n<\/jats:italic>\u00a0=\u00a09) cephalic, and 23% (<jats:italic>n<\/jats:italic>\u00a0=\u00a07) subclavian. The median access time was longer for USAA than conventional access (8.3 IQR 4.2\u201315.3 min vs. 5.2 IQR 3.4\u20138.6 min, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.009). Among the five inexperienced USAA implanters, there was a significant improvement in median access time from first to last tertile of USAA implants (17.0 IQR 7.0\u201321.0 min to 8.6 IQR 4.5\u201310.8 min, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.038). The experienced USAA implanter had similar access times with USAA compared with conventional access (4.0 IQR 3.3\u20134.7 min vs. 5.2 IQR 3.4\u20138.6 min, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.15). Venograms were less common with USAA than conventional access (2%\u00a0vs. 33%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001). The 30\u2010day complication rate was similar with USAA (<jats:italic>n<\/jats:italic>\u00a0=\u00a04\/70, 6%) versus conventional (<jats:italic>n<\/jats:italic>\u00a0=\u00a03\/30, 10%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.44).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the success rate with USAA was high, there was a significant learning curve. Once experienced with the USAA technique, there is the potential for reduced complications without adding to the procedure duration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14611","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T22:23:12Z","timestamp":1666390992000},"page":"1364-1371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["UltraSound Axillary Vein Access (USAA): Learning curve and randomized comparison to traditional venous access for cardiac device implantation"],"prefix":"10.1111","volume":"45","author":[{"given":"Alex M.","family":"Courtney","sequence":"first","affiliation":[{"name":"School of Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan K.","family":"Chandler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4984-105X","authenticated-orcid":false,"given":"John","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Noheria","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhea","family":"Pimentel","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raghuveer","family":"Dendi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rigoberto","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y. Madhu","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0543-2040","authenticated-orcid":false,"given":"Seth H.","family":"Sheldon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Kansas Health System  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460\u20109592.2001.00456.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14060"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.04.030"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw363"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ipej.2019.12.008"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw147"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13940"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14846"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540\u20108159.2006.00451.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840\u2010017\u20100273\u20103"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.03.137"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13855"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13567"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211054621"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840\u2010020\u201000800\u20103"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13961"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12833"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12917"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20108703(94)90090\u20106"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2001.111261"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra035432"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.113.003747"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840\u2010018\u20100313\u20107"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus383"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.98.7.663"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.04.039"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.14611","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pace.14611","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.14611","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T05:08:10Z","timestamp":1692508090000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.14611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,9]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1111\/pace.14611"],"URL":"https:\/\/doi.org\/10.1111\/pace.14611","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,9]]},"assertion":[{"value":"2022-04-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}