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Safety and prevention of complications during percutaneous epicardial access for the ablation of cardiac arrhythmias
Since its introduction, percutaneous epicardial access is increasingly being performed to facilitate catheter ablation of ventricular tachycardias (VTs) with epicardial circuits, difficult cases of idiopathic VTs, focal atrial tachycardia, and accessory pathways that cannot be successfully targeted endocardially.1 A thorough understanding of the clinical anatomy and potential complications is vital in order to perform a safe procedure.2 In this article, we present the clinical anatomy related to epicardial access, the technique of performing a subxiphoid epicardial puncture, and various measures to prevent complications.How to perform magnetic resonance imaging on patients with implantable cardiac arrhythmia devices
Magnetic resonance imaging (MRI) offers unrivaled soft tissue resolution and multiplanar imaging capabilities. Cardiac MRI is capable of accurate characterization of cardiac function and is uniquely capable of identifying scar fibrosis and fat deposition, thus making it an ideal imaging modality for the evaluation of patients presenting with arrhythmia. In addition, the absence of x-ray radiation makes MRI suitable for follow-up of chronic disease and for imaging in young patients and women of childbearing age.
