Subxiphoid Surgical Approach for Epicardial Catheter-Based Mapping and Ablation in Patients With Prior Cardiac Surgery or Difficult Pericardial Access

摘要: Background— Percutaneous epicardial mapping and ablation are successful in some patients with ventricular reentry circuits but may be impossible when pericardial adhesions present, such as from prior cardiac surgery. The purpose of this study was to evaluate the feasibility direct surgical exposure space allow catheter electrophysiology laboratory percutaneous access is not feasible. Methods Results— In 6 surgery or failed access, a subxiphoid window attempted. all patients, manual lysis exposed surface heart through small incision allowed placement an 8F sheath into under vision. Access diaphragmatic catheters achieved manipulation lateral anterior walls possible 4 patie...