Jun 8, 2015

Ethanol for the treatment of cardiac arrhythmias

Current Opinion in Cardiology
Paul SchurmannMiguel Valderrábano

Abstract

Ethanol infusion was an early mode of ablative treatment for cardiac arrhythmias. Its initial descriptions involved coronary intra-arterial delivery, targeting arrhythmogenic substrates in drug-refractory ventricular tachycardia or the atrioventricular node. Largely superseded by radiofrequency ablation (RFA) and other contact-based technologies as a routine ablation strategy, intracoronary arterial ethanol infusion remains as an alternative option in the treatment of ventricular tachycardia when conventional ablation fails. Arrhythmic foci that are deep-seated in the myocardium may not be amenable to catheter ablation from either the endocardium or the epicardium by RFA, but they can be targeted by an ethanol infusion. Recently, we have explored ethanol injection through cardiac venous systems, in order to avoid the risks of complications and limitations of coronary arterial instrumentation. Vein of Marshall ethanol infusion is being studied as an adjunctive procedure in ablation of atrial fibrillation, and coronary venous ethanol infusion for ventricular tachycardia. Ethanol ablation remains useful as a bail-out technique for refractory cases to RFA, or as an adjunctive therapy that may improve the efficacy of catheter ablati...Continue Reading

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Citations

Mentioned in this Paper

Atrioventricular Node Development
Ethanol
Radiofrequency Ablation
Ethanol Measurement
Ablation
Myocardium
Injection Procedure
Coronary Arteriosclerosis
Atrial Fibrillation
Endocardium Specimen

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