Acute and mid-term outcome of ethanol infusion of vein of Marshall for the treatment of perimitral flutter.

Atrial Fibrillation / surgery Atrial Flutter / diagnosis Brain Ischemia Catheter Ablation Ethanol Humans Stroke Treatment Outcome
Atrial tachycardia Catheter ablation Epicardial conduction Ethanol High-resolution mapping Vein of Marshall

Journal

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
ISSN: 1532-2092
Titre abrégé: Europace
Pays: England
ID NLM: 100883649

Informations de publication

Date de publication:
01 08 2020
Historique:
received: 18 02 2020
revised: 10 04 2020
accepted: 24 05 2020
pubmed: 1 7 2020
medline: 29 6 2021
entrez: 29 6 2020
Statut: ppublish

Résumé

We hypothesized that an epicardial approach using ethanol infusion in the vein of Marshall (EIVOM) may improve the result of ablation for perimitral flutter (PMF). We studied 103 consecutive patients with PMF undergoing high-resolution mapping. The first 71 were treated with radiofrequency (RF) ablation alone (RF-group), and the next 32 underwent EIVOM followed by RF on the endocardial and epicardial mitral isthmus (EIVOM/RF-group). Contact force was not measured during ablation. Acute and 1-year outcomes were compared. Flutter termination rates were similar between the RF-group (63/71, 88.7%) and EIVOM/RF-group (31/32, 96.8%, P = 0.27). Atrial tachycardia (AT) terminated with EIVOM alone in 22/32 (68.6%) in the EIVOM/RF-group. Bidirectional block of mitral isthmus was always achieved in the EIVOM/RF-group, but significantly less frequently achieved in the RF-group (62/71, 87.3%; P = 0.05). Median RF duration for AT termination/conversion was shorter [0 (0-6) s in the EIVOM/RF-group than 312 (55-610) s in the RF-group, P < 0.0001], as well as for mitral isthmus block in the EIVOM/RF-group [246 (0-663) s] than in the RF-group [900 (525-1310) s, P < 0.0001]. Pericardial effusion was observed in 1/32 (3.2%) in EIVOM/RF-group and 5/71 (7.0%) in RF-group (P = 0.66); two in RF-group required drainage and one of them developed subsequent ischaemic stroke. One-year follow-up demonstrated fewer recurrences in the EIVOM/RF-group [6/32 (18.8%)] than in the RF-group [29/71 (40.8%), P = 0.04]. By multivariate analysis, only EIVOM was significantly associated with less AT recurrence (hazard ratio = 0.35, P = 0.018). Ethanol infusion in the vein of Marshall may reduce RF duration required for PMF termination as well as for mitral isthmus block without severe complications, and the mid-term outcome may be improved by this approach.

Identifiants

DOI: 10.1093/europace/euaa137 PMID: 32594180
pubmed: 32594180
pii: 5864479
doi: 10.1093/europace/euaa137
doi:

Substances chimiques

Ethanol 3K9958V90M

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1252-1260

Informations de copyright

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.

Auteurs

Masateru Takigawa (M)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.
Heart Rhythm Center, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1138510, Japan.

Konstantinos Vlachos (K)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Claire A Martin (CA)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Felix Bourier (F)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Arnaud Denis (A)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Takeshi Kitamura (T)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Ghassen Cheniti (G)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Anna Lam (A)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Ruairidh Martin (R)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Antonio Frontera (A)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Nathaniel Thompson (N)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Grégoire Massoullié (G)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Michael Wolf (M)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

William Escande (W)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Clémentine André (C)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Li-Jun Zeng (LJ)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Yosuke Nakatani (Y)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Takashi Nakashima (T)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Xavier Pillois (X)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Daniel Ramirez (D)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Josselin Duchateau (J)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Thomas Pambrun (T)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Frederic Sacher (F)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Hubert Cochet (H)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Mélèze Hocini (M)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Michel Haïssaguerre (M)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Pierre Jaïs (P)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

Nicolas Derval (N)

Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux, France.

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Classifications MeSH

questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › Acute and mid-term outcome of ethanol infusion...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Flutter auriculaire › Acute and mid-term outcome of ethanol infusion...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Encéphalopathie ischémique › Acute and mid-term outcome of ethanol infusion...
questionsmedicales.fr › Procédures de chirurgie opératoire › Techniques d'ablation › Ablation par radiofréquence › Ablation par cathéter › Acute and mid-term outcome of ethanol infusion...
questionsmedicales.fr › Composés chimiques organiques › Alcools › Éthanol › Acute and mid-term outcome of ethanol infusion...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Acute and mid-term outcome of ethanol infusion...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Acute and mid-term outcome of ethanol infusion...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Acute and mid-term outcome of ethanol infusion...