{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T08:47:17Z","timestamp":1767084437489,"version":"build-2065373602"},"reference-count":14,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The axillary and cephalic veins are commonly utilized for transvenous pacemaker lead access. They typically advance to the heart through the subclavian, brachiocephalic, and superior vena cava veins. Anatomical variations such as a persistent left superior vena cava (PLSVC) may pose a challenge, necessitating an alternative approach for lead placement. This anomaly can often be identified during venographic contrast imaging or by visualizing atypical venous courses during the procedure. Another challenge occurs when the venous pathway is tortuous. Careful monitoring during the procedure is crucial to ensure that the lead follows the intended path. If not, the lead may inadvertently enter a collateral, such as the inferior thyroid vein, which drains into the internal jugular or left brachiocephalic vein. Despite these deviations, the lead may eventually reach the heart, although via an unusual course. If such a lead is left in place, even in the absence of immediate complications, long-term outcomes are unpredictable and carry the risk of unforeseen complications.<\/jats:p>","DOI":"10.3390\/jcm14134395","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T06:50:45Z","timestamp":1750402245000},"page":"4395","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Atypical Lead Pathway Leading to Vocal Cord Paralysis and Tracheostomy Following Pacemaker Implantation"],"prefix":"10.3390","volume":"14","author":[{"given":"Dariusz","family":"Jagielski","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Wroc\u0142aw University of Science and Technology, 50-370 Wroclaw, Poland"},{"name":"Department of Cardiology, Center for Heart Diseases, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jagoda","family":"Jack\u00f3w-Nowicka","sequence":"additional","affiliation":[{"name":"Department of Radiology, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5093-4085","authenticated-orcid":false,"given":"Bruno","family":"Hrymniak","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Center for Heart Diseases, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Kulbacki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroc\u0142aw University of Science and Technology, 50-370 Wroclaw, Poland"},{"name":"Faculty of Computer Science, Polish-Japanese Academy of Information Technology, 02-008 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0597-8457","authenticated-orcid":false,"given":"Joanna","family":"Bladowska","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroc\u0142aw University of Science and Technology, 50-370 Wroclaw, Poland"},{"name":"Department of Radiology, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1007\/s00330-018-5633-6","article-title":"Assessment of Cardiac Lead Perforation: Comparison Among Chest Radiography, Transthoracic Echocardiography and Electrocardiography-gated Contrast-enhanced Cardiac CT","volume":"29","author":"Zhang","year":"2019","journal-title":"Eur. 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Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1136\/hrt.2009.189910","article-title":"The challenges of transvenous lead extraction","volume":"97","author":"Maytin","year":"2011","journal-title":"Heart"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1177\/000348949310201014","article-title":"Recurrent laryngeal nerve paralysis during transvenous insertion of a permanent endocardial pacemaker","volume":"102","author":"Zohar","year":"1993","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"unstructured":"Culp, J.M., and Patel, G. (2025, March 20). Recurrent Laryngeal Nerve Injury, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560832\/.","key":"ref_7"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jacc.2024.05.003","article-title":"Transforming Cardiovascular Care with Artificial Intelligence: From Discovery to Practice: JACC state-of-the-art review","volume":"84","author":"Khera","year":"2024","journal-title":"J. Am. Coll. Cardiol."},{"doi-asserted-by":"crossref","unstructured":"Hartsock, I., and Rasool, G. (2024). Vision-language models for medical report generation and visual question answering: A review. Front. Artif. 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Electrophysiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/13\/4395\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:55:38Z","timestamp":1760032538000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/13\/4395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,20]]},"references-count":14,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["jcm14134395"],"URL":"https:\/\/doi.org\/10.3390\/jcm14134395","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,6,20]]}}}