{
  "abstract": "Percutaneous subxiphoid epicardial access for ventricular tachycardia ablation carries a substantial risk of catastrophic complications. Intentional coronary venous carbon dioxide insufflation (Epi-CO₂) creates a radiolucent pneumopericardium that provides a broad needle target, but evidence is dominated by single-center reports. We retrospectively analyzed 53 consecutive patients undergoing epicardial access for ventricular tachycardia ablation at 3 Japanese tertiary centers (Epi-CO₂, n = 28; conventional access, n = 25). Major access-related complications occurred in 0 of 28 Epi-CO₂ patients vs 3 of 25 (12.0%) conventional-access patients, including ventricular puncture, tamponade, and 2 in-hospital deaths, without prolonging total procedure time (270 vs 301 minutes; P = 0.142). Core Epi-CO₂ metrics, including CO₂ volume and epicardial-access fluoroscopy time, were consistent across all 3 centers, and all 6 high-risk patients underwent the procedure without complication. In this first Asian multicenter experience, Epi-CO₂ was associated with the absence of major access-related complications, including in anatomically challenging cases.",
  "abstract_shown": true,
  "affiliations": [
    "Heart Rhythm Center, Department of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Miyagi, Japan. Electronic address: kennosuke.atmm3@gmail.com.",
    "Heart Rhythm Center, Department of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Miyagi, Japan.",
    "Department of Cardiology, Sapporo Heart Center, Sapporo, Hokkaido, Japan. Electronic address: https://twitter.com/yuheyheyheyhey.",
    "Department of Cardiology, Sapporo Heart Center, Sapporo, Hokkaido, Japan. Electronic address: https://twitter.com/EPsamurai1982.",
    "Cardiac Electrophysiology and Pacing Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.",
    "Department of Cardiology, Kameda Medical Center, Kamogawa, Chiba, Japan. Electronic address: https://twitter.com/akmizukami."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kennosuke Yamashita"
    },
    {
      "affs": [
        1
      ],
      "name": "Keita Yoshiyama"
    },
    {
      "affs": [
        2
      ],
      "name": "Yuhei Kasai"
    },
    {
      "affs": [
        3
      ],
      "name": "Takayuki Kitai"
    },
    {
      "affs": [
        4
      ],
      "name": "Koji Higuchi"
    },
    {
      "affs": [
        1
      ],
      "name": "Yohei Kikuchi"
    },
    {
      "affs": [
        1
      ],
      "name": "Daiki Kumazawa"
    },
    {
      "affs": [
        1
      ],
      "name": "Yosuke Mizuno"
    },
    {
      "affs": [
        1
      ],
      "name": "Kosuke Onodera"
    },
    {
      "affs": [
        5
      ],
      "name": "Akira Mizukami"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2pm9wddft2192.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jacasi.2026.08.017",
  "fulltext_url": "https://europepmc.org/articles/PMC13654430",
  "id": "2pm9wddft2192",
  "issns": [
    "2772-3747"
  ],
  "landing_url": "https://europepmc.org/article/MED/42841572",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Cardiac Arrhythmias and Treatments"
    ]
  ],
  "openalex": "W7220673420",
  "pdf_url": "https://europepmc.org/articles/PMC13654430?pdf=render",
  "pmcid": "PMC13654430",
  "pmid": "42841572",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2pm9wddft2192.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:10Z",
      "native_id": "MED:42841572",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42841572"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac Arrhythmias and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Multicenter Coronary Venous Carbon Dioxide Insufflation for Subxiphoid Epicardial Access in Ventricular Tachycardia Ablation.",
  "title_text": "Multicenter Coronary Venous Carbon Dioxide Insufflation for Subxiphoid Epicardial Access in Ventricular Tachycardia Ablation.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:10Z",
  "url": "https://research.draconitic.com/paper/2pm9wddft2192",
  "venue": "JACC. Asia",
  "versions": []
}