{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T18:41:01Z","timestamp":1772131261447,"version":"3.50.1"},"reference-count":19,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Cardiac implantable electronic device (CIED) implants and electrophysiological procedures share a common step: vascular access. On behalf of the AIAC Ricerca Investigators\u2019 Network, we conducted a survey to outline Italian common practice regarding vascular access in EP-lab. All Italian physicians with experience in CIED implantation and electrophysiology were invited to answer an online questionnaire (from May 2020 to November 2020) featuring 20 questions. In total, 103 cardiologists (from 92 Italian hospitals) answered the survey. Vascular access during CIED implants was considered the most complex step following lead placement by 54 (52.4%) respondents and the most complex for 35 (33.9%). In total, 54 (52.4%) and 49 (47.6%) respondents considered the cephalic and subclavian vein the first option, respectively (intrathoracic and extrathoracic subclavian\/axillary vein by 22 and 27, respectively). In total, 45 (43.7%) respondents performed close arterial femoral accesses manually; only 12 (11.7%) respondents made extensive use of vascular closure devices. A total of 46 out of 103 respondents had experience in ultrasound-guided vascular accesses, but only 10 (22%) used it for more than 50% of the accesses. In total, 81 (78.6%) respondents wanted to increase their ultrasound-guided vascular access skills. Reducing complications is a goal to reach in cardiac stimulation and electrophysiological procedures. Our survey shows the heterogeneity of the vascular approaches used in Italian centres. Some vascular accesses were proved to be superior to others in terms of complications, with ultrasound-guided puncture as an emerging technique. More effort to produce the standardization of vascular accesses could be made by scientific societies.<\/jats:p>","DOI":"10.3390\/biology11020265","type":"journal-article","created":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T01:03:40Z","timestamp":1644368620000},"page":"265","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Vascular Accesses in Cardiac Stimulation and Electrophysiology: An Italian Survey Promoted by AIAC (Italian Association of Arrhythmias and Cardiac Pacing)"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3617-2739","authenticated-orcid":false,"given":"Matteo","family":"Ziacchi","sequence":"first","affiliation":[{"name":"Department of Experimental, Institute of Cardiology, Diagnostic and Specialty Medicine, University of Bologna, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Placci","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, University Hospital of Parma, 41100 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Angeletti","sequence":"additional","affiliation":[{"name":"Department of Experimental, Institute of Cardiology, Diagnostic and Specialty Medicine, University of Bologna, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1605-0059","authenticated-orcid":false,"given":"Fabio","family":"Quartieri","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Santa Maria Nuova Hospital of Reggio Emilia, 42100 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Balla","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Sant\u2019Anna University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santo","family":"Virzi","sequence":"additional","affiliation":[{"name":"Department of Emergency, Division of Cardiology, SS.ma Annunziata Hospital, 44042 Cento, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-7140","authenticated-orcid":false,"given":"Matteo","family":"Bertini","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Sant\u2019Anna University Hospital of Ferrara, 44124 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3278-1721","authenticated-orcid":false,"given":"Roberto","family":"De Ponti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Insubria, Circolo e Fondazione Macchi di Varese Hospital, 21100 Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4590-8584","authenticated-orcid":false,"given":"Mauro","family":"Biffi","sequence":"additional","affiliation":[{"name":"Department of Experimental, Institute of Cardiology, Diagnostic and Specialty Medicine, University of Bologna, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico Di Modena, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for AIAC Ricerca Investigators\u2019 Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1093\/europace\/euaa367","article-title":"EHRA expert consensus statement and practical guide on optimal implantation technique for conventional pacemakers and implantable cardioverter-defibrillators: Endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS)","volume":"23","author":"Burri","year":"2021","journal-title":"Europace"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1093\/europace\/eut345","article-title":"Preferred tools and techniques for implantation of cardiac electronic devices in Europe: Results of the European Heart Rhythm Association survey","volume":"15","author":"Bongiorni","year":"2013","journal-title":"Europace"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.jacep.2020.01.006","article-title":"Subclavian and Axillary Vein Access Versus Cephalic Vein Cutdown for Cardiac Implantable Electronic Device Implantation: A Meta-Analysis","volume":"6","author":"Atti","year":"2020","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1093\/europace\/euy165","article-title":"Cephalic vs. subclavian lead implantation in cardiac implantable electronic devices: A systematic review and meta-analysis","volume":"21","author":"Benz","year":"2019","journal-title":"Europace"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/j.1540-8159.1993.tb01607.x","article-title":"Anatomical mechanisms explaining damage to pacemaker leads, defibrillator leads, and failure of central venous catheters adjacent to the sternoclavicular joint","volume":"16","author":"Magney","year":"1993","journal-title":"Pacing Clin. Electrophysiol. 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PACE"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1016\/j.hrthm.2020.04.030","article-title":"Axillary vein puncture guided by ultrasound vs cephalic vein dissection in pacemaker and defibrillator implant: A multicenter randomized clinical trial","volume":"17","author":"Tagliari","year":"2020","journal-title":"Heart Rhythm"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1093\/europace\/euw363","article-title":"Self-taught axillary vein access without venography for pacemaker implantation: Prospective randomized comparison with the cephalic vein access","volume":"19","author":"Squara","year":"2017","journal-title":"Europace"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.jvs.2018.05.019","article-title":"A systematic review of vascular closure devices for femoral artery puncture sites","volume":"68","author":"Noori","year":"2018","journal-title":"J. Vasc. Surg."},{"key":"ref_14","first-page":"CD009541","article-title":"Vascular closure devices for femoral arterial puncture site haemostasis","volume":"3","author":"Robertson","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"13761","DOI":"10.1038\/srep13761","article-title":"Network Meta-analysis of Randomized Trials on the Safety of Vascular Closure Devices for Femoral Arterial Puncture Site Haemostasis","volume":"5","author":"Jiang","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1001\/jama.2014.15305","article-title":"Comparison of vascular closure devices vs manual compression after femoral artery puncture: The ISAR-CLOSURE randomized clinical trial","volume":"312","author":"Helde","year":"2014","journal-title":"Jama"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1056\/NEJMoa1516333","article-title":"Registry-Based Prospective, Active Surveillance of Medical-Device Safety","volume":"376","author":"Resnic","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e003560","DOI":"10.1161\/CIRCINTERVENTIONS.116.003560","article-title":"Relationship between Femoral Vascular Closure Devices and Short-Term Mortality From 271 845 Percutaneous Coronary Intervention Procedures Performed in the United Kingdom between 2006 and 2011: A Propensity Score-Corrected Analysis From the British Cardiovascular Intervention Society","volume":"9","author":"Farooq","year":"2016","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s00059-015-4306-3","article-title":"Comparison of Exo-Seal((R)) and Angio-Seal ((R)) for arterial puncture site closure: A randomized, multicenter, single-blind trial","volume":"40","author":"Ketterle","year":"2015","journal-title":"Herz"}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/11\/2\/265\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:16:19Z","timestamp":1760134579000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/11\/2\/265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,8]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["biology11020265"],"URL":"https:\/\/doi.org\/10.3390\/biology11020265","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,8]]}}}