Epicardial cryoablation via a subxiphoid approach offers a reversible and stable alternative for treating idiopathic PVCs inaccessible via the coronary venous system.
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May offer reversible epicardial access for select PVCs; leaves open need for prospective safety and efficacy data.
Key Teaching Points•Epicardial cryoablation can be performed percutaneously by accessing the pericardial space through a subxiphoid approach.•Epicardial cryoablation can be considered for epicardial idiopathic premature ventricular contractions that cannot be accessed through the coronary venous system with a radiofrequency ablation catheter.•Cryoablation is reversible during the cryomapping mode and also provides catheter stabilization by adhering to tissue in order to reduce damage to adjacent structures. •Epicardial cryoablation can be performed percutaneously by accessing the pericardial space through a subxiphoid approach.•Epicardial cryoablation can be considered for epicardial idiopathic premature ventricular contractions that cannot be accessed through the coronary venous system with a radiofrequency ablation catheter.•Cryoablation is reversible during the cryomapping mode and also provides catheter stabilization by adhering to tissue in order to reduce damage to adjacent structures.
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Abrich et al. (2019) studied this question.
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