Impact of Vein of Marshall Ethanol Infusion on Mitral Isthmus Block: Efficacy and Durability.

Circulation. Arrhythmia and Electrophysiology
Takashi NakashimaNicolas Derval

Abstract

Achieving bidirectional mitral isthmus (MI) block using radiofrequency catheter ablation (RFCA) alone is challenging, and MI reconnection is common. Adjunctive vein of Marshall (VOM) ethanol infusion (VOM-Et) can facilitate acute MI block. However, little is known about its long-term success. This study sought to evaluate the impact of adjunctive VOM-Et on MI block achievement and durability compared with RFCA alone. Patients undergoing the first attempt of posterior MI ablation were grouped according to their MI block index strategy: adjunctive VOM-Et and RFCA alone. Rates of acute MI block and MI reconnection observed during repeat procedures were compared between the 2 groups. The VOM-Et group consisted of 152 patients (63.8±9.4 years) undergoing adjunctive VOM-Et for MI block. The RFCA group consisted of 110 patients (60.9±9.2 years) undergoing MI ablation using RFCA alone. Acute MI block was more frequently achieved in the VOM-Et group (98.7% [150/152] versus 63.6% [70/110]; P<0.001) with shorter RFCA duration (5.00 [3.00-7.00] versus 19.0 [13.6-22.0] minutes; P<0.001). Of the 220 patients with MI block achieved during the index procedure, 81 underwent a repeat procedure during follow-up (VOM-Et group: 23.3% [35/150] versu...Continue Reading

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Citations

Feb 19, 2021·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Philipp KrisaiMélèze Hocini
Mar 21, 2021·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Takamitsu TakagiNicolas Derval
Mar 10, 2021·Pacing and Clinical Electrophysiology : PACE·Konstantinos VlachosMélèze Hocini
May 1, 2021·Journal of Cardiovascular Electrophysiology·Anna LamLaurent Roten
May 25, 2021·Journal of Cardiovascular Electrophysiology·Masayuki IshimuraYoshio Kobayashi
Jul 24, 2021·JACC. Clinical Electrophysiology·Tsukasa KamakuraThomas Pambrun
Jul 28, 2021·Journal of Cardiovascular Electrophysiology·Yosuke NakataniThomas Pambrun
Jul 20, 2021·Circulation. Arrhythmia and Electrophysiology·Tsukasa KamakuraThomas Pambrun
Aug 30, 2021·JACC. Clinical Electrophysiology·Mikael LaredoAlexandre Zhao

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