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- Title
The effect of an initial catheter ablation with an adjunctive ethanol infusion into the vein of Marshall on persistent atrial fibrillation.
- Authors
Shimizu, Yukiko; Yoshitani, Kazuyasu; Kuriyama, Tomoari; Mori, Kazuki; Kujira, Kazuto; Imai, Masao; Fukuhara, Rei; Taniguchi, Ryoji; Toma, Masanao; Miyamoto, Tadashi; Sato, Yukihito
- Abstract
Introduction: Some previous studies have reported that a first‐step ethanol infusion into the vein of Marshall (EIVOM) with touch‐up radiofrequency (RF) ablation can facilitate mitral isthmus (MI) block and improves the ablation outcomes in persistent atrial fibrillation (PeAF) patients. However, the effect of an initial RF ablation with an adjunctive EIVOM has not been fully investigated. Methods: This study enrolled 233 PeAF patients undergoing pulmonary vein isolation and linear ablation including an MI, roof line, and cavotricuspid isthmus ablation. An EIVOM was performed when endocardial ablation with or without coronary sinus ablation failed to create MI block. Results: Bidirectional MI block was achieved in 224 patients (96.1%). Among them, MI block was obtained by only RF ablation in 174/224 patients (77.7%) (RF group) and an adjunctive EIVOM was needed in 50/224 (22.3%) (EIVOM group). During the follow‐up, 113 (64.9%) RF group patients were free from AF/atrial tachycardia compared to 41 (82.0%) EIVOM group patients (log‐rank p =.045). In a multivariate Cox regression analysis, an adjunctive EIVOM was associated with a lower recurrence rate (hazard ratio = 0.39, 95% confidence interval = 0.17–0.78, p =.006). Conclusion: An initial RF ablation with an adjunctive EIVOM strategy improved MI ablation's acute success rate and was associated with better clinical outcomes.
- Subjects
PULMONARY veins; ETHANOL; TREATMENT effectiveness; DESCRIPTIVE statistics; RADIO frequency therapy; MULTIVARIATE analysis; INTRAVENOUS therapy; LOG-rank test; ATRIAL fibrillation; CATHETER ablation; COMPARATIVE studies; DISEASE relapse; CONFIDENCE intervals; EVALUATION
- Publication
Journal of Cardiovascular Electrophysiology, 2024, Vol 35, Issue 3, p453
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.16191