Characteristics and treatment of pericarditis after vein of Marshall Ethanol infusion for persistent atrial fibrillation

Background: The vein of Marshall ethanol infusion (VOM-EI) provides an opportunity to achieve bidirectional conduction block of mitral isthmus. However, this technique may induce traumatic pericarditis. There is a lack of research on which populations are prone to pericarditis after VOM-EI and how to treat it more effectively. Methods: This retrospective study included 77 consecutive patients who voluntarily underwent persistent atrial fibrillation radiofrequency ablation combined with VOM-EI. With the occurrence of postoperative pericarditis as the end point, the characteristics and risk factors of postoperative pericarditis were analyzed. The curative effect was evaluated by the symptom relief rate of pericarditis 48 hours after treatment. Results: 15 had postoperative pericarditis among the 77 patients, accounting for 19.5%. The hospital stay of the patients with pericarditis was longer than that without pericarditis (10.0 vs 8.0 days, P = 0.045). Of the 15 patients with postoperative pericarditis, 8 received colchicine. Among the patients treated with colchicine, the average treatment intensity was 1.04 mg/d, 7 patients were relieved within 48 hours, and the symptomatic remission rate was 87.5%. Among the remaining 7 patients who did not receive colchicine, only 2 patients had symptomatic remission. Compared with the group without colchicine, the duration of symptoms was significantly shorter (27.88 vs 51.93 hours, P = 0.024). In the multivariate logistic regression analysis, colchicine was the only effective method to relieve the 48 hours symptoms of postoperative pericarditis ( OR =17.500, CI 1.223-250.4, P = 0.035). Conclusion: Postoperative pericarditis is one of the complications of VOM-EI, and colchicine may have a good short-term effect on it.