ArticleClinical research in cardiology : official journal of the German Cardiac Society2021
Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Advances in Epicardial Access for Ventricular Tachycardia Ablation: From Historical Techniques to Carbon Dioxide Insufflation.Reviews in cardiovascular medicine · 2026Review
- Epicardial Ventricular Tachycardia Ablation: A Contemporary Review of Indications, Techniques, and Practical Approaches for Challenging Substrates.Reviews in cardiovascular medicine · 2026Review
- Hemorrhagic Pericardial Effusion and Gastrointestinal Bleed After Atrial Fibrillation Epicardial Ablation: A Case Report.Clinical case reports · 2025Article
- Epicardial ventricular tachycardia ablation: safety and efficacy of access and ablation using low-iodine content.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Epicardial ventricular arrhythmia ablation: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology and the Heart Rhythm Society, the Asian Pacific Heart Rhythm Society, the Latin American Heart Rhythm Society, and the Canadian Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Near-Infrared Spectroscopic Mapping of the Human Epicardium.Journal of biophotonics · 2025Article
- Left internal thoracic artery injury in percutaneous epicardial access for catheter ablation: Prevention and management.HeartRhythm case reports · 2025Article
- Pre- and post-procedural cardiac imaging (computed tomography and magnetic resonance imaging) in electrophysiology: a clinical consensus statement of the European Heart Rhythm Association and European Association of Cardiovascular Imaging of the European Society of Cardiology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Use of three-dimensional electroanatomic mapping for epicardial access: needle tracking, electrographic characteristics, and clinical application.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Prevention and treatment of pericardial tamponade in the electrophysiology laboratory: a European Heart Rhythm Association survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Complications of catheter ablation for ventricular tachycardia.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Review
- [Puncture techniques in invasive cardiac electrophysiology].Herzschrittmachertherapie & Elektrophysiologie · 2021Article
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Authors and funding
13 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPericardial access for ablation of ventricular arrhythmias (VA) can be gained either by an anterior-oriented or inferior-oriented epicardial puncture under fluoroscopical guidance. We retrospectively sought to assess the safety of these two puncture techniques and the incidence of epicardial adhesions and introduce our algorithm for management of pericardial tamponade. METHODS AND
resultsIn 211 patients (61.4 ± 15.6 years, 179 males; 84.8%) 271 epicardial ablation procedures of VA were performed using either an anterior- or inferior-oriented approach for epicardial access. Puncture-related complications were systematically analyzed. Furthermore, the incidence of adhesions was evaluated during first and repeated procedures. A total of 34/271 (12.5%) major complications occurred and 23/271 (8.5%) were directly related to epicardial puncture. The incidence of puncture-related major complications in the anterior and inferior group was 4/82 (4.9%) and 19/189 (10.1%), respectively. Pericardial tamponade was the most common major complication (15/271; 5.5%). Collateral damages of adjacent structures such as liver, colon, gastric vessels and coronary arteries occurred in 6/189 (3.2%) patients and only within the inferior epicardial access group. Adhesions were documented in 19/211 (9%) patients during the first procedure and in 47.1% if patients had 2 or more procedures involving epicardial access.
conclusionAnterior-oriented epicardial puncture shows an observed association to a reduced incidence of pericardial tamponades and overall puncture-related complications in epicardial ablation of VA. In cases of repeated epicardial access adhesions increase significantly and may lead to ablation failure.
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