ReviewReviews in cardiovascular medicine2026
Advances in Epicardial Access for Ventricular Tachycardia Ablation: From Historical Techniques to Carbon Dioxide Insufflation.
Review in Reviews in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
Epicardial access is often required for effective catheter ablation of ventricular tachycardia (VT) originating from the epicardium, especially in patients with non-ischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy (ARVC), and cardiac sarcoidosis. Traditional subxiphoid access using large-bore needles remains effective but carries substantial procedural risks, including right ventricular (RV) puncture, coronary artery injury, and injury to intra-abdominal organs. These risks are amplified in patients with prior cardiac surgery, obesity, and distorted anatomy. To mitigate these challenges, several technical advancements have been introduced, including the needle-in-needle (micropuncture) technique and the SAFER approach using RV angiography during apnea. However, these methods do not fully overcome the inherent limitation of minimal separation between the pericardial layers at the time of pericardial puncture. Carbon dioxide (CO
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