Arrhythmias & electrophysiology
Sustained Apnea for Epicardial Access With Right Ventriculography: The SAFER Epicardial Approach
Authors' conclusion
The SAFER epicardial approach is a simple, efficient, effective, and low-cost technique easily reproducible across multiple centers. It is associated with lower complication rates than previously reported techniques for EA.
Study context
- Population
- Consecutive patients undergoing epicardial access (VT ablation, left atrial appendage closure, phrenic nerve displacement), June 2021 to February 2023
- Participants
- 105 patients
- Exposure
- SAFER epicardial approach vs previously reported epicardial access (EA) techniques
- SAFERn = 105
- Outcome
- Successful EA (efficacy); RV perforation, major hemorrhagic pericardial effusion, bleeding requiring surgery (safety)
Methodological detailscomparison with previous studies
- Comparison with previous studies
Main finding
As reported in the abstract
Successful EA
EA successful in all subjects
100%
Observational data: associations, not effects.
Secondary outcomes
Time to EA
- Median time to EA (IQR 5-14 minutes)
- 7 minutes
Indication for EA
- VT ablation
- 98 (93.4%)
- Left atrial appendage closure
- 6 (5.7%)
- Phrenic nerve displacement
- 1 (0.9%)
Major pericardial bleeding vs previous studies of other EA techniques
- Significant reduction with SAFER approach
Safety
Right ventricular (RV) perforation, major hemorrhagic pericardial effusion (HPE), bleeding requiring surgical intervention
- No cases of RV perforation, HPE or need of surgical intervention
Original publication
Sustained Apnea for Epicardial Access With Right Ventriculography: The SAFER Epicardial Approach. JACC Clin Electrophysiol. Published 18 May 2023. doi:10.
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