Novel approach to pulmonary vein isolation ablation via right internal jugular access: A case report

Table 1 Risks and benefits of internal jugular vein, transhepatic, azygous vein, and subclavian vein access

Access point	Benefits	Risks
Internal jugular vein	Rapid ultrasound-guided access	Pneumothorax
	Lower bleeding risk	Arterial injury
	Ability to accommodate large bore sheaths	Potential jugular stenosis
	High first-attempt success rate
	Lower rates of arterial puncture and hematoma with ultrasound guidance
Transhepatic access	Bypass thoracic complications	Bleeding risk
	Useful in patients with contraindications to thoracic access	Hepatic capsular perforation
Azygous vein	Alternative if all other options limited	Technically demanding with small vessel caliber
Subclavian vein	Lower risk of catheter-related bloodstream infection and thrombosis	Higher risk of pneumothorax and subclavian artery cannulization