Pericardiocentesis : This is usually done by the cardiologist. It is better done with ECG and haemodynamic monitoring. Subxyphoid route is preferred with the patient positioned at 45" angle. In ECG controlled technique the hub of the aspiration needle is connected to an electrode. When the exploring needle touches the epicardiuin it produces an ectopic pattern. Better than ECG control,
Echocardio graphically controlled pericardiocentesis is the procedure of choice these days. Here the exact tip of the needle is visible thus avoiding myocardial injury. For diagnostic purpose, needle aspiration is adequate. However for therapeutic purpose, insertion of a pigtail catheter and drainage is a safer method.