Epicardial approach for cardiac electrophysiology procedures.
Since its introduction over two decades ago, percutaneous epicardial procedures have become well‐adopted by cardiac electrophysiologists, most commonly for catheter ablation of cardiac arrhythmias as well as left atrial appendage closure. The percutaneous epicardial approach has also been utilized f...
| Published in: | Journal of Cardiovascular Electrophysiology Vol. 31; no. 1; pp. 345 - 360 |
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| Main Authors: | , |
| Format: | diagnostic images pictorial review tracings Journal Article |
| Published: |
Wiley-Blackwell
Jan2020
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141251904&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141251904 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jan2020 vid: 31 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 141251904 141251904 141251904 10.1111/jce.14282 141251904 ppf: 345 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Epicardial approach for cardiac electrophysiology procedures. aug: au: Aryana, Arash d'Avila, André affil: Department of Cardiology and Cardiac Electrophysiology, Mercy General Hospital and Dignity Health Heart and Vascular Institute, Sacramento California sug: subj: Catheter Ablation Methods Electrophysiology Evaluation Myocardial Diseases Diagnosis, Cardiovascular Tachycardia, Ventricular Diagnosis Heart Catheterization Methods Pericardium Anatomy and Histology Heart Atrium, Left Pathology Radiofrequency Ablation Methods ab: Since its introduction over two decades ago, percutaneous epicardial procedures have become well‐adopted by cardiac electrophysiologists, most commonly for catheter ablation of cardiac arrhythmias as well as left atrial appendage closure. The percutaneous epicardial approach has also been utilized for cardiac pacing and drug delivery. But still, its most common usage is for the treatment of intramural and subepicardial substrates that give rise to ventricular tachycardia, particularly in patients with nonischemic cardiomyopathy. In fact, subxiphoid, percutaneous epicardial mapping and ablation have emerged as an important adjunct and in some cases the preferred strategy for characterizing and treating certain types of ventricular arrhythmias. Herein, we will review the indications and rationale for various epicardial procedures. Additionally, we will explore the anatomy of the pericardium as well as the frequently‐used epicardial access techniques. We will further examine the optimal approaches and methodologies for epicardial mapping and ablation and the impact of epicardial fat. We will also discuss the epicardial technique for left atrial appendage closure for the purpose of embolic stroke risk reduction. Finally, we will consider the potential for various complications in the setting of epicardial procedures along with their risk factors and discuss strategies to mitigate such adverse events. pubtype: Academic Journal doctype: diagnostic images pictorial review tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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