{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:16:10Z","timestamp":1787508970060,"version":"build-2736575974"},"reference-count":6,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Leadless pacemakers traditionally rely on femoral venous access, which may be limited in patients with unfavorable IVC anatomy, prior interventions, or situations where preserving femoral access is preferred. Internal jugular (IJ) access offers an alternative route, but real\u2010world data on IJ implantation of single\u2010 and dual\u2010chamber leadless devices remain limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To describe patient characteristics, procedural details, and outcomes of pacemaker implantation via IJ access.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We performed a retrospective case series of five patients who underwent Abbott Aveir leadless pacemaker implantation\u2014ventricular (VR), atrial (AR), or dual\u2010chamber\u2014via right and left IJ access at a single center. Demographics, indications, rationale for IJ access, procedural course, and acute device parameters were reviewed. Outcomes included procedural success, access\u2010related complications, and device performance at discharge.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All five patients (mean age 41\u00b1 21 years; 40% female; BMI 25.9 \u00b1 6.7\u00a0kg\/m\n 2<\/jats:sup>\n ) underwent successful IJ access implantation. Indications for pacemaker included intermittent complete heart block (\n n<\/jats:italic>\n = 1), sinus node dysfunction (\n n<\/jats:italic>\n = 4). Reasons for selecting IJ access included avoidance of femoral access in young active patients (\n n<\/jats:italic>\n = 2), complex IVC anatomy with failed femoral advancement (\n n<\/jats:italic>\n = 1), improved sheath control and trajectory for atrial leadless deployment (\n n<\/jats:italic>\n = 1), and concern that patient could not tolerate post procedure precautions due to neurocognitive disorder. Acute device performance was favorable. VR devices demonstrated pacing thresholds 0.25\u20131.0\u00a0V @ 0.4\u00a0ms, R\u2010wave amplitudes 8.9\u201317.9\u00a0mV, and impedance 410\u2013910\u00a0\u03a9. AR devices showed thresholds 0.75\u20135.0\u00a0V @ 0.4\u00a0ms, P\u2010wave amplitudes 0.5\u20134.4\u00a0mV, and impedance 320\u2013910\u00a0\u03a9. Dual\u2010chamber systems had stable parameters in both chambers. There were no intraprocedural or access\u2010related complications, including no pneumothorax, hematoma, venous thrombosis, embolization, or hemodynamic instability. All patients had stable device function at discharge.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n IJ vein access is a feasible and safe alternative for pacemaker implantation in patients with limited femoral access, including pediatric and complex adult populations. This approach allows effective device placement and stable pacing outcomes, avoiding femoral\u2010related vascular complications. Further studies are needed to validate reproducibility and long\u2010term performance.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/pace.70358","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T07:03:10Z","timestamp":1783494190000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Internal Jugular Vein as an Alternative Access for Pacemaker Implantation: A Mostly Left IJ Case Series"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0032-1130","authenticated-orcid":false,"given":"Maya Asami","family":"Takagi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of California Davis Health System Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Leon","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of California Davis Health System Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of California Davis Health System Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-0733","authenticated-orcid":false,"given":"Daniel","family":"Cortez","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology University of California Davis Health System Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf119"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae199"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840\u2010025\u201002135\u20103"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/IMCRJ.S529596"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2300080"},{"key":"e_1_2_14_7_1","unstructured":"A.Swanson.Abbott Receives FDA Approval for World's First Dual Chamber Leadless Pacemaker. Abbott Press Release 5 July 2023 https:\/\/abbott.mediaroom.com\/2023-07-05-Abbott-Receives-FDA-Approval-for-Worlds-First-Dual-Chamber-Leadless-Pacemaker."}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.70358","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pace.70358","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.70358","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T07:03:17Z","timestamp":1783494197000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.70358"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":6,"alternative-id":["10.1111\/pace.70358"],"URL":"https:\/\/doi.org\/10.1111\/pace.70358","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"assertion":[{"value":"2026-04-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pace.70358"}}