Impact of Vein of Marshall Ethanol Infusion on Mitral Isthmus Block: Efficacy and Durability.
Aged
Arrhythmias, Cardiac
/ diagnosis
Atrial Fibrillation
/ diagnosis
Catheter Ablation
/ adverse effects
Coronary Vessels
/ diagnostic imaging
Ethanol
/ administration & dosage
Female
Heart Rate
Humans
Male
Middle Aged
Pulmonary Veins
/ physiopathology
Recurrence
Retrospective Studies
Time Factors
Treatment Outcome
Veins
/ diagnostic imaging
atrial fibrillation
catheter ablation
coronary sinus
ethanol
tachycardia
Journal
Circulation. Arrhythmia and electrophysiology
ISSN: 1941-3084
Titre abrégé: Circ Arrhythm Electrophysiol
Pays: United States
ID NLM: 101474365
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
pubmed:
17
11
2020
medline:
16
3
2021
entrez:
16
11
2020
Statut:
ppublish
Résumé
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]; Beyond facilitating acute MI block, VOM-Et is associated with greater lesion durability as evidenced by higher rates of MI block during repeat procedures.
Sections du résumé
BACKGROUND
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.
METHODS
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.
RESULTS
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];
CONCLUSIONS
Beyond facilitating acute MI block, VOM-Et is associated with greater lesion durability as evidenced by higher rates of MI block during repeat procedures.
Identifiants
pubmed: 33197321
doi: 10.1161/CIRCEP.120.008884
doi:
Substances chimiques
Ethanol
3K9958V90M
Types de publication
Comparative Study
Journal Article
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM