TY - JOUR
T1 - Initial international multicenter human experience with a novel epicardial access needle embedded with a real-time pressure/frequency monitoring to facilitate epicardial access
T2 - Feasibility and safety
AU - Di Biase, Luigi
AU - Burkhardt, J. David
AU - Reddy, Vivek
AU - Romero, Jorge
AU - Neuzil, Petr
AU - Petru, Jan
AU - Sadiva, Lucie
AU - Skoda, Jan
AU - Ventura, Miguel
AU - Carbucicchio, Corrado
AU - Dello Russo, Antonio
AU - Csanadi, Zoltan
AU - Casella, Michela
AU - Fassini, Gaetano M.
AU - Tondo, Claudio
AU - Sacher, Frederic
AU - Theran, Mike
AU - Dukkipati, Srinivas
AU - Koruth, Jacob
AU - Jais, Pierre
AU - Natale, Andrea
N1 - Publisher Copyright:
© 2017 Heart Rhythm Society
PY - 2017/7
Y1 - 2017/7
N2 - Background Epicardial ablation is often necessary for the treatment of complex arrhythmias refractory to endocardial ablation. Conventional needle access to the pericardial space is considered quite challenging, and it is often associated with several potential complications, particularly inadvertent right ventricular puncture. The novel EpiAccess needle tip is embedded with a pressure sensor able to report the pressure waveform in real time when used with the EpiAccess System. Objective We prospectively evaluated the feasibility and safety of the EpiAccess System by EpiEP, Inc., with a novel epicardial access needle in a multicenter study. Methods Twenty-five patients with a clinical need for epicardial access were enrolled. The EpiAccess needle and EpiAccess System were used for epicardial access in each case. Successful epicardial access, defined as the ability to introduce a guidewire into the epicardial space, was assessed via the device and confirmed with fluoroscopy. Significant pericardial bleeding was defined as >80 mL of blood by using peer review article definitions. Results Patients were men (76%) with a mean age of 62 years (range 28-84 years). Epicardial access for ventricular tachycardia ablation was indicated in 80% of the patients. Successful epicardial access was obtained in all cases, with pressure monitoring guiding pericardial wire access in all cases. One delayed pericardial effusion occurred. Conclusion Epicardial access with the novel EpiAccess needle and System with real-time pressure monitoring is feasible and safe. The pressure monitoring capability identifies successfully the epicardial space, facilitating access and potentially minimizing complications. This has relevant clinical implications.
AB - Background Epicardial ablation is often necessary for the treatment of complex arrhythmias refractory to endocardial ablation. Conventional needle access to the pericardial space is considered quite challenging, and it is often associated with several potential complications, particularly inadvertent right ventricular puncture. The novel EpiAccess needle tip is embedded with a pressure sensor able to report the pressure waveform in real time when used with the EpiAccess System. Objective We prospectively evaluated the feasibility and safety of the EpiAccess System by EpiEP, Inc., with a novel epicardial access needle in a multicenter study. Methods Twenty-five patients with a clinical need for epicardial access were enrolled. The EpiAccess needle and EpiAccess System were used for epicardial access in each case. Successful epicardial access, defined as the ability to introduce a guidewire into the epicardial space, was assessed via the device and confirmed with fluoroscopy. Significant pericardial bleeding was defined as >80 mL of blood by using peer review article definitions. Results Patients were men (76%) with a mean age of 62 years (range 28-84 years). Epicardial access for ventricular tachycardia ablation was indicated in 80% of the patients. Successful epicardial access was obtained in all cases, with pressure monitoring guiding pericardial wire access in all cases. One delayed pericardial effusion occurred. Conclusion Epicardial access with the novel EpiAccess needle and System with real-time pressure monitoring is feasible and safe. The pressure monitoring capability identifies successfully the epicardial space, facilitating access and potentially minimizing complications. This has relevant clinical implications.
KW - Catheter ablation
KW - Epicardial access
KW - Left atrial appendage closure
KW - Micropuncture needle
KW - Subxiphoid approach
KW - Tuohy needle
KW - Ventricular tachycardia
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U2 - 10.1016/j.hrthm.2017.02.033
DO - 10.1016/j.hrthm.2017.02.033
M3 - Article
C2 - 28267588
AN - SCOPUS:85020923322
SN - 1547-5271
VL - 14
SP - 981
EP - 988
JO - Heart Rhythm
JF - Heart Rhythm
IS - 7
ER -