March 9, 2021Pacing and Clinical Electrophysiology
Ligament of Marshall ablation for persistent atrial fibrillation
Why the study?
Beyond pulmonary vein isolation, additional ablation strategies for persistent atrial fibrillation remain controversial, and discrete anatomical structures like the Vein or Ligament of Marshall have epicardial muscular bundles frequently involved in re-entry.
Does ethanol ablation of the Vein of Marshall supplemented with RF ablation improve conduction block at the mitral isthmus compared to repeat RF ablation alone in patients with persistent atrial fibrillation?
Population
Patients with persistent atrial fibrillation
Comparison
Ligament of Marshall / Vein of Marshall ablation… vs Repeat radiofrequency (RF) ablation alone
Design
Review
Authors
Discussion
Loading...
Member takes
Implication
May support adjunctive VOM ethanol ablation for mitral isthmus block in persistent AF; leaves open need for randomized trials before practice change.
Structured PICO
Does ethanol ablation of the Vein of Marshall supplemented with RF ablation improve conduction block at the mitral isthmus compared to repeat RF ablation alone in patients with persistent atrial fibrillation?
P
Population
Patients with persistent atrial fibrillation
I
Intervention
Ligament of Marshall (LOM) / Vein of Marshall (VOM) ablation using ethanol infusion, supplemented with radiofrequency (RF) ablation
C
Comparator
Repeat radiofrequency (RF) ablation alone
O
Outcome
Conduction block at the mitral isthmussurrogate
Ethanol ablation of the Vein of Marshall may be an effective adjunctive strategy to achieve mitral isthmus block in persistent atrial fibrillation.
Cite This Study
Vlachos et al. (2021) studied this question.