Common parts of the procedure
compressive bandage
SKIN, PNEUMOTHORAX
In each group, in case of difficulties with the vascular access, operators had the option of using a hydrophilic guidewire, intravenous volume expansion, Trendelenburg position, or venous angiography.After venous access was achieved, procedures were identical in both groups. Lead implantation was guided by fluoroscopy (Cios Alpha mobile C-arm, Siemens, Munich, Germany). The fluoroscopic system was configured to low-dose mode with low frame rates (5 frames/s) and proper collimation. Endocardial active or passive fixation leads were used in all patients. Atrial leads were implanted in the right atrial appendage, and right ventricle leads were positioned on the interventricular septum or at the right ventricular apex. The generator was placed in a pre-pectoral subcutaneous pocket. Skin was closed with absorbable thread. After dressing was applied, a compressive bandage (with roll and tape) was placed immediately and left until the following day.After the procedure, the CIED pocket and the suture were examined daily until discharge. A chest X-ray was systematically performed within 24 h of the procedure to check for stability of the lead positioning and the absence of pneumothorax. Cardiac implantable electronic devices control was performed post-implantation and before patient discharge.Each patient underwent an 8-day and a 3-month post-operative follow-up consultation with an electrophysiologist for pocket skin examination, electrocardiogram recording, and CIED interrogation.