Techniques for Percutaneous Access

Zachary Hale, Austin Howard, Yang Yang, Nilesh Mathuria

Research output: Contribution to journalReview articlepeer-review


Percutaneous epicardial access continues to have a growing role within cardiac electrophysiology. The classic approach has typically been with a Tuohy needle via a subxiphoid approach guided by fluoroscopic landmarks and tactile feedback. Recent developments have highlighted the role of the micropuncture needle, electroanatomic mapping, and real-time pressure sensors to reduce complications. Further, different access sites, such as the right atrial appendage, have been described and may offer a novel approach to percutaneous epicardial access. In addition, future directions of percutaneous access may involve direct visualization, near-field impedance monitoring, and real-time virtual imaging.

Original languageEnglish (US)
Pages (from-to)271-280
Number of pages10
JournalCardiac Electrophysiology Clinics
Issue number3
StatePublished - Sep 2020


  • Catheter ablation
  • Epicardial access
  • Percutaneous
  • Pericardial

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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