Vein of Marshall ethanol infusion can lead to uncontrolled lesions in the left atrium, including transient left atrial appendage isolation, which operators should be aware of.
Transient LAA isolation after VOMEI warrants caution on acute endpoints; leaves open durability and role in perimitral flutter ablation.
A 58-year-old woman was referred for atrial flutter ablation after atrial fibrillation ablation. Linear and reinforcement mitral isthmus ablation failed to terminate the perimitral flutter. During vein of Marshall ethanol infusion (VOMEI), the flutter was terminated and followed by left atrial appendage (LAA) isolation. Voltage mapping showed that a large low voltage area was created in the superior and anterior wall of left atrium. During the waiting time, the LAA activation recovered. It would be necessary to keep in mind that VOMEI would lead to uncontrolled lesion of left atrium.
No takes yet. Share an insight, caveat, or question.
Lu et al. (2024) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: