Ultrasound Guided Vascular Access for CIED Implantation: A Step-by-Step Guide

Introduction: Vascular access is required for most cardiac electrophysiology procedures. Over the past two decades, ultrasound guidance has increased in utilization as the primary method for assisting operators in gaining access for cardiac implantable electronic device (CIED) implantation. Methods Ultrasound guidance using a technique that includes both short-axis and long-axis views combined with a twisting needle motion after maximal tenting provides an extremely safe and reproducible technique for vascular access for all CIED procedures. Results and Conclusions In this manuscript and accompanying videos, the author will provide a step-by-step guide for optimal ultrasound guided visualization and needle maneuver technique to maximize safety and efficiency for vascular access in all CIED procedures.