Outcome of Ultrasound-Guided Versus Fluoroscopy-Guided Versus Cephalic Cutdown Permanent Pacemaker Implantation

Ultrasound-guided access was associated with the lowest observed complication rate, although this was not statistically significant, likely reflecting limited sample size. Radiation exposure varied significantly by access method, with ultrasound guidance offering an intermediate profile between cephalic cutdown and fluoroscopy. These findings support the safety of ultrasound-guided access and highlight the need for larger studies to confirm its role in reducing complications and radiation burden in PPM implantation.