Section of Electrophysiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 9 Founders Pavilion, Philadelphia, PA, 19104, USA.
J Interv Card Electrophysiol. 2023 Jan;66(1):109-116. doi: 10.1007/s10840-022-01338-2. Epub 2022 Aug 13.
Pericardial access from a subxiphoid approach is often necessary to gain access to a critical epicardial substrate that is inaccessible from the endocardium. Although relatively safe, a rate of up to 5% of acute and 2% delayed complications has been reported. Intentional perforation of a distal coronary vein branch with pericardial insufflation of CO to create a negative contrast space anterior to the right ventricle is an emerging approach to facilitate pericardial access. In this report, we describe the technique of intentional coronary vein exit with CO insufflation to perform epicardial mapping and ablation of ventricular tachycardia (VT) in a step-by-step approach and review the published literature on this topic.
经剑突下入路获取心外膜途径通常是必需的，以便获取无法从心内膜到达的关键心外膜基质。尽管相对安全，但据报道，急性并发症的发生率高达 5%，延迟并发症的发生率高达 2%。经心外膜向心包内吹入 CO 以故意刺穿远端冠状静脉分支，在右心室前形成负性对比空间，这是一种新兴的方法，有助于获取心包途径。在本报告中，我们描述了经 CO 吹入故意刺穿冠状静脉出口的技术，以便逐步进行心外膜标测和消融室性心动过速（VT），并回顾了该主题的已发表文献。
