Devices, systems, and methods for accessing the internal and external tissuesof the heart are disclosed. At least some of the embodiments disclosed hereinprovide access to the external surface of the heart through the pericardial spacefor localized delivery of substances to the heart tissue. In addition, variousdisclosed embodiments provide access to the internal surface of the heart foraspiration and delivery of substances to a targeted region without disturbingor interfering with nearby structures or surfaces.