Remote Navigation and Electroanatomic Mapping in the Pericardial Space

Mapping and ablation in the pericardial space has been shown to be beneficial for the treatment of different supraventricular and ventricular arrhythmias. The percutaneous subxiphoid approach is the most frequently used approach to access the pericardial space. Mapping and ablation in this space may be challenging because it is an open space without obstacles where catheters can move freely, making some locations difficult to reach. Remote magnetic navigation is a modern way to overcome many of the limitations the electrophysiologist encounters during mapping and ablation of arrhythmias in the pericardial space. This article recounts the authors' experiences and reviews the limited data on this topic.