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All roads lead to the heart, but not always. A complex case of a hemodialysis patient requiring permanent cardiac pacing, with no vascular access for either conventional or leadless pacemaker implantation Cover

All roads lead to the heart, but not always. A complex case of a hemodialysis patient requiring permanent cardiac pacing, with no vascular access for either conventional or leadless pacemaker implantation

Romanian Journal of Cardiology
AHEAD OF PRINT
By: Demetra Emanuela Rotaru,  Alexandru Achim,  Bogdan Vasiliu,  Irina Sandu and  Stefan Horia Rosianu  
Open Access
|Jan 2026

Figures & Tables

Figure 1

Atrial fibrillation, left bundle branch block.
Atrial fibrillation, left bundle branch block.

Figure 2

1 A, B Annular calcification extending to the mitral-aortic continuity and aortic root; 2 A-Important left ventricular hypertrophy; B-Toothpaste tumour.
1 A, B Annular calcification extending to the mitral-aortic continuity and aortic root; 2 A-Important left ventricular hypertrophy; B-Toothpaste tumour.

Figure 3

1- Oclussion VCS due to ‘forgotten* dialysis catheter; 2 - Stenosis and oclussion of inferior vena cava and collateral circulation between the left common iliac vein and the left renal vein.
1- Oclussion VCS due to ‘forgotten* dialysis catheter; 2 - Stenosis and oclussion of inferior vena cava and collateral circulation between the left common iliac vein and the left renal vein.

Figure 4

3- Important collateral circulation thoraco-abdominal; 4- Important collateral circulation thoraco-abdominal.
3- Important collateral circulation thoraco-abdominal; 4- Important collateral circulation thoraco-abdominal.

Figure 5

X ray-pacemaker and epicardial lead placement.
X ray-pacemaker and epicardial lead placement.
DOI: https://doi.org/10.2478/rjc-2025-0041 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X
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Language: English
Published on: Jan 12, 2026
Published by: Romanian Society of Cardiology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
leadless,
vena cava,
occlusion,
vascular,
atrioventricular block
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Cardiology,
Surgery,
Cardiac surgery,
Pediatrics and juvenile medicine,
Paediatric cardiology

© 2026 Demetra Emanuela Rotaru, Alexandru Achim, Bogdan Vasiliu, Irina Sandu, Stefan Horia Rosianu, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.

AHEAD OF PRINT