Arrhythmias & electrophysiologyDiagnostic or prognostic study
Use of three-dimensional electroanatomic mapping for epicardial access: needle tracking, electrographic characteristics, and clinical application
- Feasibility and validation study (animal and human)
Authors' conclusion
By tracking NT in the 3D EAM system and continuously monitoring the NT electrogram, it is feasible and safe to obtain EA with minimum or no fluoroscopic guidance.
Study context
- Population
- Pigs and patients undergoing epicardial access (pericardiocentesis)13 pigs · 22 patients
- Participants
- 13 vs 22
- Comparison
- 3D electroanatomic mapping (EAM)-guided epicardial access with needle-tip electrogram
- Pigsn = 13
- Patientsn = 22
- Outcome
- Feasibility of epicardial access guided by 3D EAM with needle-tip electrogram
Performance
As reported in the abstract
Epicardial access success
- Epicardial access successfully obtained without complication in 13 pigs and 22 patients
Further findings
Needle tip (NT) potential amplitude, pigs (mediastinum / fibrous pericardium / pericardial sac)
- Mediastinum
- 3.2 ± 1.0 mV
- Fibrous pericardium
- 5.2 ± 1.6 mV
- Pericardial sac
- 9.8 ± 2.8 mV
- all P ≤ 0.001
NT potential amplitude, patients (mediastinum / fibrous pericardium / pericardial sac)
- Mediastinum
- 1.54 ± 0.40 mV
- Fibrous pericardium
- 3.61 ± 1.08 mV
- Pericardial sac
- 7.15 ± 2.88 mV
- all P < 0.001
Fluoroscopy time by case order
- Animals 1-4 / 5-8 / 9-13
- 64 ± 15, 23 ± 17, and 0 s; P = 0.01
- Patients 1-7 / 8-14 / 15-22
- 44 ± 23, 31 ± 18, 4±7 s; P < 0.001
- Epicardial access (EA) without X-ray exposure
- five pigs and seven patients
Safety
events
| Outcome | Pigs | Patients |
|---|---|---|
| Complications | 0 | 0 |
Original publication
Use of three-dimensional electroanatomic mapping for epicardial access: needle tracking, electrographic characteristics, and clinical application. Europace. Published 8 April 2024. doi:10.1093/europace/euae089
Summarised from the published abstract; every number is checked against it