A suction tool for accessing the epicardium of the heart through an incision through the pericardium and into the pericardial space to ablate myocardium tissue comprising: a suction tool body extending between a suction tool body proximal end and a suction tool body distal end; and an elongated suction pad extending between a suction pad proximal end and a suction pad distal end, the suction pad proximal end attached to the suction tool body distal end, the suction pad shaped to have a suction cavity adapted to be applied against tissue, the suction cavity defined by an elongated, substantially concave suction cavity wall bounded by a suction cavity rim, a plurality of suction ports extending through the suction cavity wall into the suction cavity, the suction pad distal end shaped with a leader to fit through a pericardial incision and a tissue dilator to be inserted through the pericardial incision to facilitate advancement of the suction pad into the pericardial space, the suction pad comprising one or more ablation electrodes, the suction tool body further comprising: a suction lumen extending from a proximal suction fitting adapted to be coupled to a vacuum source and to the plurality of suction ports through which suction can be applied to the pericardium to draw a pericardial bleb of the pericardium into the suction cavity when the suction cavity wall is applied against the pericardium and through which suction can be applied to the epicardium to draw a myocardial bleb of the myocardium into the suction cavity when the suction pad is inserted through an incision of the pericardium into the suction cavity wall and applied against the epicardium; and a working lumen extending between a working lumen proximal end opening and a working lumen distal end opening into the suction cavity, the working lumen adapted to receive an ablation tool having one or more electrodes for ablating myocardium tissue. a suction tool body extending between a suction tool body proximal end and a suction tool body distal end; and an elongated suction pad extending between a suction pad proximal end and a suction pad distal end, the suction pad proximal end attached to the suction tool body distal end, the suction pad shaped to have a suction cavity adapted to be applied against tissue, the suction cavity defined by an elongated, substantially concave suction cavity wall bounded by a suction cavity rim, a plurality of suction ports extending through the suction cavity wall into the suction cavity, the suction pad distal end shaped with a leader to fit through a pericardial incision and a tissue dilator to be inserted through the pericardial incision to facilitate advancement of the suction pad into the pericardial space, the suction pad comprising one or more ablation electrodes, the suction tool body further comprising: a suction lumen extending from a proximal suction fitting adapted to be coupled to a vacuum source and to the plurality of suction ports through which suction can be applied to the pericardium to draw a pericardial bleb of the pericardium into the suction cavity when the suction cavity wall is applied against the pericardium and through which suction can be applied to the epicardium to draw a myocardial bleb of the myocardium into the suction cavity when the suction pad is inserted through an incision of the pericardium into the suction cavity wall and applied against the epicardium; and a working lumen extending between a working lumen proximal end opening and a working lumen distal end opening into the suction cavity, the working lumen adapted to receive an ablation tool having one or more electrodes for ablating myocardium tissue. a suction lumen extending from a proximal suction fitting adapted to be coupled to a vacuum source and to the plurality of suction ports through which suction can be applied to the pericardium to draw a pericardial bleb of the pericardium into the suction cavity when the suction cavity wall is applied against the pericardium and through which suction can be applied to the epicardium to draw a myocardial bleb of the myocardium into the suction cavity when the suction pad is inserted through an incision of the pericardium into the suction cavity wall and applied against the epicardium; and a working lumen extending between a working lumen proximal end opening and a working lumen distal end opening into the suction cavity, the working lumen adapted to receive an ablation tool having one or more electrodes for ablating myocardium tissue.