Ethanol Infusion via the Vein of Marshall for Focal Left Atrial Appendage Atrial Tachycardia

Figures

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  Figure 1. Electrocardiogram and Initial Activation Mapping (A) 12-lead electrocardiogram demonstrating atrial tachycardia. (B) Activation mapping indicated that the tachycardia originated from a focal lesion in the LAA. (C) Ablation at the region of the earliest activation was ineffective. LAA = left atrial appendage.

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  Figure 2. Repeat Activation Mapping, Ethanol Infusion Into VOM and Electrocardiogram (A) The earliest activation site is adjacent to the region of the left superior pulmonary vein ridge inside the LAA. (B) Ablation at the region of the earliest activation was ineffective. (C) Coronary sinus angiography shows the VOM (white arrow). (D) Ethanol infusion into the VOM (yellow arrows). (E) The AT gradually terminated during the ethanol infusion. (F) After the completion of ethanol infusion, the AT disappeared completely. AT = atrial tachycardia; LAA = left atrial appendage; VOM = vein of Marshall.