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Novel Subxiphoid Cut Down Approach to Facilitate Epicardial Catheter Ablation in an Obese Patient
Anvi Raina1, Siva K Mulpuru1, Christopher V DeSimone1
1Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Introduction:
Dry epicardial access to facilitate epicardium mapping and ablation is a well described technique with increasing use in modern electrophysiology. However, traditional percutaneous access can be challenging is obese patients or those with anatomical variations.
Methods And Results:
We report on a case where a subxiphoid cut down was utilized for epicardial access in a patient with morbid obesity. This approach allows us to reach the epicardial space when traditional needles do not suffice and enables a more controlled access, potentially minimizing the risk of damage to nearby structures.
Conclusion:
Subxiphoid cut down to facilitate percutaneous epicardial access is a simple and effective option when traditional epicardial access is not feasible due to morbid obesity or anatomical variations.

