The Pericardial Space: Obtaining Access and an Approach to Fluoroscopic Anatomy

The pericardial space is now increasingly used as a means and vantage point for mapping and ablating various arrhythmias. In this review, present techniques to access the pericardial space are examined and potential improvements over this technique discussed. The authors then examine in detail the regional anatomy of the pericardial space relevant to the major arrhythmias treated in contemporary electrophysiology. In each of these sections, emphasis is placed on anatomic fluoroscopic correlation and avoiding complications that may result.