Feasibility of endoscopic guidance for nonsurgical transthoracic atrial and ventricular epicardial ablation

摘要: Background Epicardial catheter ablation via subxiphoid percutaneous access currently is used upon failure of endocardial ablation. The safety, efficacy, and applicability epicardial likely will improve with direct visualization the pericardial space. Objective purpose this study was to assess feasibility endoscopic guidance for identification anatomic landmarks Methods Dual femoral venous arterial were obtained in six healthy swine. endoscope electrophysiology advanced Anatomic identified endoscopy confirmed by multiview fluoroscopic assessment proximity catheters area interest. Radiofrequency selected targets performed under guidance. Targeting lesions assessed pathologic examination target surrounding structures. Results large-bore without complications all animals. coronary sinus, left anterior descending artery, atrial appendage, pulmonary veins easily visualized Catheter targets, including right ventricular outflow tract, veins, successfully observation. Endoscopic point linear near vessels also assessed. Pathology revealed successful targeting lesions. Conclusion electrophysiologic procedures feasible. Direct structures, catheters, may safety efficacy reduce staff patient radiation exposure.