Arrhythmias & electrophysiology
Assessment of pericardial adhesions by means of the EpiCO2 technique: Brighton Adhesion Classification
Authors' conclusion
The EpiCO2 technique allows assessment of the presence of pericardial adhesions prior to attempting subxiphoid puncture for epicardial access, which may lead to a reduction in the procedural complications within this subset of patients.
Study context
- Population
- Consecutive epicardial ablation procedures assessed for pericardial adhesions by the EpiCO2 technique (coronary vein exit and CO2 insufflation) before subxiphoid puncture
- Participants
- 235 consecutive procedures
- Exposure
- BAC-0 vs BAC-1a vs BAC-1b vs BAC-2
- BAC-0n = 219
- BAC-1an = 9
- BAC-1bn = 2
- BAC-2n = 5
- Outcome
- Efficacy of the EpiCO2 technique in diagnosing pericardial adhesions (Brighton Adhesion Classification (BAC)) prior to subxiphoid puncture
Methodological detailsconsecutive procedures
- Consecutive procedures
Main finding
As reported in the abstract
Pericardial adhesions by BAC
- Intentional coronary vein exit achieved in all procedures (right atrial appendage exit in 1 case)
- 235
Observational data: associations, not effects.
Further findings
Procedural consequences of adhesion diagnosis
- Subxiphoid puncture not attempted
- 6 cases (2.6%)
- Epicardial mapping abandoned due to limited catheter movement
- 1 case (0.4%)
Safety
- Access-related complications — BAC-0
- 3%
- Access-related complications: occurred only in the BAC-0 group
Original publication
Assessment of pericardial adhesions by means of the EpiCO2 technique: Brighton Adhesion Classification. Heart Rhythm. Published 9 May 2024. doi:10.
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