{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T12:36:06Z","timestamp":1784810166946,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"publisher","award":["Z181100001718174"],"award-info":[{"award-number":["Z181100001718174"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Nature Science Foundation of China","doi-asserted-by":"publisher","award":["82170318"],"award-info":[{"award-number":["82170318"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Nature Science Foundation of China","doi-asserted-by":"publisher","award":["81870244"],"award-info":[{"award-number":["81870244"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Pericardiocentesis is usually completed under fluoroscopy. The electroanatomic mapping (EAM) system allows visualizing puncture needle tip (NT) while displaying the electrogram recorded from NT, making it possible to obtain epicardial access (EA) independent of fluoroscopy. This study was designed to establish and validate a technique by which EA is obtained under guidance of three-dimensional (3D) EAM combined with NT electrogram.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>3D shell of the heart was generated, and the NT was made trackable in the EAM system. Unipolar NT electrogram was continuously monitored. Penetration into pericardial sac was determined by an increase in NT potential amplitude and an injury current. A long guidewire of which the tip was also visible in the EAM system was advanced to confirm EA. Epicardial access was successfully obtained without complication in 13 pigs and 22 patients. In the animals, NT potential amplitude was 3.2 \u00b1 1.0\u2005mV when it was located in mediastinum, 5.2 \u00b1 1.6\u2005mV when in contact with fibrous pericardium, and 9.8 \u00b1 2.8\u2005mV after penetrating into pericardial sac (all P \u2264 0.001). In human subjects, it measured 1.54 \u00b1 0.40\u2005mV, 3.61 \u00b1 1.08\u2005mV, and 7.15 \u00b1 2.88\u2005mV, respectively (all P &amp;lt; 0.001). Fluoroscopy time decreased in every 4\u20135 cases (64 \u00b1 15, 23 \u00b1 17, and 0\u2005s for animals 1\u20134, 5\u20138, 9\u201313, respectively, P = 0.01; 44 \u00b1 23, 31 \u00b1 18, 4\u00b17\u2005s for patients 1\u20137, 8\u201314, 15\u201322, respectively, P &amp;lt; 0.001). In five pigs and seven patients, EA was obtained without X-ray exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>By tracking NT in the 3D EAM system and continuously monitoring the NT electrogram, it is feasible and safe to obtain EA with minimum or no fluoroscopic guidance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euae089","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T12:11:01Z","timestamp":1712578261000},"source":"Crossref","is-referenced-by-count":9,"title":["Use of three-dimensional electroanatomic mapping for epicardial access: needle tracking, electrographic characteristics, and clinical application"],"prefix":"10.1093","volume":"26","author":[{"given":"Ronghui","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University , Beijing , China"},{"name":"Department of Cardiology, The First Affiliated Hospital of Anhui Medical University , Hefei , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7133-1577","authenticated-orcid":false,"given":"Binquan","family":"You","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine , Suzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9905-7899","authenticated-orcid":false,"given":"Haixiong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanxi Cardiovascular Hospital, Shanxi Institute of Cardiovascular Diseases , Taiyuan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfei","family":"Ruan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6256-3189","authenticated-orcid":false,"given":"Songnan","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Scottsdale, AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1228-2581","authenticated-orcid":false,"given":"Peter J","family":"Weiss","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Banner University Medical Center Phoenix, University of Arizona College of Medicine -Phoenix, 1111 E. 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