title: Thorax Percutaneous Approach for Epicardial Ventricular Ablation in a Patient with Electrical Storm.
abstract: Subxiphoid puncture is considered the standard approach for epicardial ablation of ventricular arrhythmia, but in some cases this access is impracticable due to the patient's anatomy. We describe the case of a patient with electrical storm and abnormal subdiaphragmatic anatomy that precluded the usual subxiphoid approach. In this patient the pericardial space was gained through a direct thorax puncture at the fifth intercostals space close to the mammary line. The tools and technique utilized in this case were similar to what is usually used for traditional subxiphoid puncture. The thorax percutaneous puncture was successfully carried out without complication.
authors.affiliation: Cardiology Department, Maggiore Hospital, Bologna, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Barbato
authors.affiliation: Cardiology Department, Maggiore Hospital, Bologna, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Carinci
authors.affiliation: Thoracic Surgery Department, Maggiore Hospital, Bologna, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Fortiparri
authors.affiliation: Cardiology Department, Maggiore Hospital, Bologna, Italy.
authors.forename: Piercamillo
authors.initials: P
authors.lastname: Pavesi
authors.affiliation: Cardiology Department, Maggiore Hospital, Bologna, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pergolini
authors.affiliation: Cardiology Department, Maggiore Hospital, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: DI Pasquale
mesh_terms: D017115:Catheter Ablation / Q000379:methods*; D056149:Epicardial Mapping / Q000379:methods; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000601:surgery*; D011677:Punctures / Q000379:methods*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000601:surgery*
keywords: electrical storm; epicardial ablation; epicardial approach; ventricular tachycardia