Intentional Right Atrial Exit and Carbon Dioxide Insufflation to Facilitate Subxiphoid Needle Entry Into the Empty Pericardial Space: First Human Experience

Document Type

Article

Publication Date

10-1-2015

Publication Title

JACC Clin Electrophysiol

Abstract

OBJECTIVES: The purpose of this study was to test whether a microcatheter can safely be advanced across the right atrial appendage to access the pericardium and then withdrawn despite subsequent high-intensity anticoagulation. We also tested whether transatrial pericardial insufflation of carbon dioxide (CO

BACKGROUND: Subxiphoid needle access to the empty pericardium, required for left atrial suture ligation and epicardial ablation for rhythm disorders, risks myocardial or coronary laceration.

METHODS: A catheter from the femoral vein engaged the right atrial appendage for angiographic confirmation of position. Through that catheter, the back end of a 0.014- or 0.018-inch guidewire crossed the right atrial wall to enter the pericardium and delivered a 2.4-F microcatheter. CO

RESULTS: Right atrial exit succeeded in 11 subjects (85%) and failed uneventfully in 2 subjects. CO

CONCLUSIONS: We report the first human intentional transatrial exit procedure. Transatrial microcatheter access to the pericardium can be achieved safely. Pericardial insufflation with CO

PubMed ID

26618198

Volume

1

Issue

5

First Page

434

Last Page

441

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