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Permanent Transfemoral Pacing: Making Things Easier. Permanent pacemakers are usually implanted using the venous tributaries of the arms. There are clinical situations where this approach may not be ideal or even possible. In these situations, techniques for permanent pacing via the tributaries of the legs can be used. We describe a method of pacing via a femoral venous approach using a subcutaneous pocket. This technique provides a safe alternative pacing site when avoiding the chest and neck regions.