| Pressure frequency characteristics of the pericardial space and thorax during subxiphoid access for epicardial ventricular tachycardia ablation. | |
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MedLine Citation:
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PMID: 20156612 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Nonsurgical subxiphoid pericardial access may be useful in ventricular tachycardia ablation and other electrophysiologic procedures but has a risk of right ventricular puncture. OBJECTIVE: The purpose of this study was to identify a signature pressure frequency that would help identify the pericardial space and guide access. METHODS: The study consisted of 20 patients (8 women and 12 men; mean age 59.1 +/- 14.2 years; left ventricular ejection fraction 25.2% +/- 12.2%; failed 1.8 +/- 0.5 endocardial ablations; unresponsive to 2.0 +/- 1.0 antiarrhythmic drugs; 6 ischemic cardiomyopathy, 12 nonischemic cardiomyopathy, 2 normal heart; 4 previous sternotomy) undergoing epicardial ventricular tachycardia ablation. After pericardial access was obtained, a 10Fr long sheath was used to record pressure inside the pericardium and pleural space. Pressures were analyzed using a fast Fourier transform to identify dominant frequencies in each chamber. RESULTS: Mean pressures in the pleural space and the pericardium were not different (7.7 +/- 1.9 mmHg vs 7.8 +/- 0.9 mmHg, respectively). However, the pericardial space in each patient demonstrated two frequency peaks that correlated with heart rate (1.16 +/- 0.21 Hz) and respiratory rate (0.20 +/- 0.01 Hz), whereas the pleural space in each patient had a single peak correlating with respiratory rate (0.20 +/- 0.01 Hz). CONCLUSION: The pericardial space demonstrates a signature pressure frequency that is significantly different from the surrounding space. This difference may make minimally invasive subxiphoid pericardial access safer for nonsurgeons and may have important implications for electrophysiologic procedures. |
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Authors:
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Srijoy Mahapatra; Jason Tucker-Schwartz; David Wiggins; George T Gillies; Pamela K Mason; George McDaniel; Damien J Lapar; Christopher Stemland; Eduardo Sosa; John D Ferguson; T Jared Bunch; Gorav Ailawadi; Mauricio Scanavacca |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-01-15 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 7 ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-23 Completed Date: 2011-06-13 Revised Date: 2011-07-26 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 604-9 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia 22908, USA. mahapatra@virginia.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Catheter Ablation
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adverse effects,
methods* Electrophysiology Female Fourier Analysis Heart Ventricles / injuries Humans Male Middle Aged Pericardium* Pressure* Prospective Studies Risk Factors Statistics as Topic Sternotomy Stroke Volume Tachycardia, Ventricular / surgery* Thorax* Time Factors Ventricular Function, Left |
| Grant Support | |
ID/Acronym/Agency:
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T32 HL007849-10/HL/NHLBI NIH HHS; T32HL007849/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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Heart Rhythm. 2010 May;7(5):610-1
[PMID:
20206322
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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