Implantation of a biventricular implantable cardioverter defibrillator via the femoral vein.

Permanent pacing with access gained via the femoral vein has been described since 1980. Here we describe implantation of a biventricular implantable cardioverter defibrillator (ICD) in a case where normal implantation using thoracic venous access was not possible due to anatomical anomalies. The advantages of this technique over epicardial pacing in such a case are discussed, as are the practical difficulties involved when applying this technique to the implantation of a biventricular ICD.