Drug deposition into the intrapericardial space is favourable for achieving localised effects and targeted cardiac delivery owing to its proximity to the myocardium as well as facilitating optimised pharmacokinetic profiles and a reduction in systemic side effects. Access to the pericardium requires invasive procedures but the risks associated with this have been reduced with technological advances, such as combining transatrial and subxiphoid access with different guidance methods. A variety of introducer devices, ranging from needles to loop-catheters, have also been developed and validated in pre-clinical studies investigating intrapericardial delivery of therapeutic agents. Access techniques are generally well-tolerated, self-limiting and safe, although some rare complications associated with certain approaches have been reported. This review covers these access techniques and how they have been applied to the delivery of drugs, cells, and biologicals, demonstrating the potential of intrapericardial delivery for treatments in cardiac arrhythmia, vascular damage, and myocardial infarction.

药物沉积到心包内空间有利于实现局部效应和靶向心脏递送，因为它靠近心肌，并有助于优化药代动力学曲线和减少全身副作用。进入心包需要侵入性手术，但与此相关的风险随着技术进步而降低，例如将经心房和剑突下进入与不同的引导方法相结合。从针头到环形导管的各种导引装置也已在研究心包内输送治疗剂的临床前研究中得到开发和验证。尽管已经报道了与某些方法相关的一些罕见并发症，但访问技术通常具有良好的耐受性、自限性和安全性。