Ethanol infusion into the vein of Marshall incorporated into pulmonary vein isolation significantly increases the success rate of mitral isthmus block and clinical outcomes of persistent AF ablation.
Does ethanol infusion into the vein of Marshall improve the success rate of mitral isthmus block and clinical outcomes in patients with persistent atrial fibrillation undergoing catheter ablation?
Ethanol infusion into the vein of Marshall is a promising adjunctive strategy to improve mitral isthmus block and clinical outcomes in persistent atrial fibrillation ablation.
Catheter ablation for persistent atrial fibrillation (PeAF) is particularly challenging, as the clinical outcomes are modest. Pulmonary vein isolation (PVI) plus linear ablation is one of the main strategies for PeAF ablation. Completely durable transmural lesions are difficult to achieve by catheter ablation during mitral isthmus ablation. The ligament of Marshall contains the vein of Marshall (VOM), myocardial tracts and innervation, and serves as arrhythmogenic foci that make it an attractive target in catheter ablation of atrial fibrillation. Additionally, it co-localizes with the mitral isthmus, and may serve as a part of the perimitral isthmus reentrant circuit. Ethanol infusion into the VOM results in rapid ablation of the neighboring myocardium and its innervation. Its incorporation into PVI significantly increases the success rate of mitral isthmus block and the clinical outcome of PeAF ablation.
He et al. (Tue,) conducted a review in Persistent Atrial Fibrillation (PeAF). Ethanol infusion of Vein of Marshall (VOM) was evaluated. Ethanol infusion into the vein of Marshall incorporated into pulmonary vein isolation significantly increases the success rate of mitral isthmus block and clinical outcomes of persistent AF ablation.