Percutaneous pericardial access for electrophysiological studies in patients with prior cardiac surgery: approach and understanding the risks

Ammar M. Killu, Samuel J Asirvatham

Research output: Contribution to journalArticle

1 Scopus citations


Introduction: The number of procedures for which percutaneous pericardial access is used for has gradually increased since its initial description, and now includes mapping/ablation, atrial appendage ligation and pericardial biopsy. Areas covered: Successful percutaneous pericardial access is predicated on having a thorough understanding of regional anatomy, indications for attempting pericardial puncture and potential complications with appropriate management which are highlighted in this review. In addition, we will discuss the access technique itself, provide tips and pitfalls and highlight future directions with an emphasis on patients with prior cardiac surgery. Expert commentary: Percutaneous epicardial access, especially in patients with prior cardiac surgery, is associated with significant complications and therefore meticulous preparation is required. Even in experienced centers, unusual circumstances may be crossed.

Original languageEnglish (US)
JournalExpert Review of Cardiovascular Therapy
StateAccepted/In press - Jan 1 2018



  • Ablation
  • adhesions
  • arrhythmia
  • pericardiocentesis
  • pericardium

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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