Epicardial left ventricular mapping using subxiphoid video pericardioscopy.

We report a novel subxiphoid video pericardioscopy approach for epicardial mapping that allows direct visualization of the epicardium with minimal use of fluoroscopy. The FLEXview system (Boston Scientific Cardiac Surgery, Santa Clara, CA), which is capable of a free navigation around the heart owing to its flexible neck, was inserted into the pericardial space through a small subxiphoid incision. A commercially available mapping catheter advanced through the working port of the device could be navigated around virtually the entire biventricular epicardial surface.

Characterization of the infarct substrate and ventricular tachycardia circuits with noncontact unipolar mapping in a porcine model of myocardial infarction.

Background: Conventional mapping of ventricular tachycardia (VT) after myocardial infarction is limited in patients with hemodynamically untolerated or noninducible VT.

Objectives: The purpose of this study was to develop a unique strategy using noncontact unipolar mapping to define infarct substrate and VT circuits.

Methods: Dynamic substrate mapping (DSM) was performed in seven pigs with healed anterior myocardial infarction.