title: Pressure-frequency sensing subxiphoid access system for use in percutaneous cardiac electrophysiology: prototype design and pilot study results.
abstract: We have designed, built, and tested an early prototype of a novel subxiphoid access system intended to facilitate epicardial electrophysiology, but with possible applications elsewhere in the body. The present version of the system consists of a commercially available insertion needle, a miniature pressure sensor and interconnect tubing, read-out electronics to monitor the pressures measured during the access procedure, and a host computer with user-interface software. The nominal resolution of the system is < 0.1 mmHg, and it has deviations from linearity of < 1%. During a pilot series of human clinical studies with this system, as well as in an auxiliary study done with an independent method, we observed that the pericardial space contained pressure-frequency components related to both the heart rate and respiratory rate, while the thorax contained components related only to the respiratory rate, a previously unobserved finding that could facilitate access to the pericardial space. We present and discuss the design principles, details of construction, and performance characteristics of this system.
authors.affiliation: Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22904, USA. jmt5w@virginia.edu
authors.forename: Jason M
authors.initials: JM
authors.lastname: Tucker-Schwartz
authors.forename: George T
authors.initials: GT
authors.lastname: Gillies
authors.forename: Mauricio
authors.initials: M
authors.lastname: Scanavacca
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sosa
authors.forename: Srijoy
authors.initials: S
authors.lastname: Mahapatra
mesh_terms: D055011:Ablation Techniques; D002138:Calibration; D054849:Cardiac Electrophysiology / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D009339:Needles; D010496:Pericardium / Q000502:physiology / Q000601:surgery; D010865:Pilot Projects; D011312:Pressure; D014159:Transducers