Comparison of the effect of ethanol infusion into the vein of Marshall between with and without collateral veins
CLINICAL TRIAL REGISTRATION: Our retrospective study was conducted without registration in the UMIN Clinical Trial Registry.
Disclosures: None.
Abstract
Background
Despite the potential benefits of ethanol infusion into the vein of Marshall (EIVOM) for atrial fibrillation (AF) ablation, concerns about its reversible and unpredictable effects persist.
Objective
To assess the effectiveness of EIVOM in the vein of Marshall (VOM) with collateral veins (CVs) during mitral isthmus and AF ablation.
Methods
We included 142 AF patients. EIVOM was performed before radiofrequency ablation, and low-voltage areas (<0.5 mV) were measured before, immediately after, and 1 h after EIVOM.
Results
Among the 142 patients, 93 (65%) underwent EIVOM, and among these, 35 (37%) were found to have CVs. In the VOM with CVs group, areas with low voltage measured 0 (0–1.85) cm2 before EIVOM, 6.9 (4.1–11.2) cm2 immediately after EIVOM, and 5.7 (3.5–10.6) cm2 1 h after EIVOM. Conversely, in the group designated as VOM without CVs—from which the nine leakage cases were excluded—the areas measured 0 (0–1.35) cm2, 5.5 (2.6–11.8) cm2, and 4.7 (1.8–13.5) cm2 at the respective time points. MI line block was fully achieved in 89% (31/35) of cases in the VOM with CVs group and 88% (44/49) in the VOM without CVs groups (p = .94). There was no significant difference in the outcome of AF ablation between these groups (log-rank p = .73). Additionally, no significant difference was observed between EIVOM (+) and EIVOM (−) groups (log-rank p = .59).
Conclusion
EIVOM effectively creates MI line block, and its beneficial effects are sustained for at least 1 h after the procedure despite the low-voltage areas showing a slight reduction in size.
CONFLICT OF INTEREST STATEMENT
Yoshio Kobayashi has received remuneration for lectures from Amgen Astellas BioPharma Co., Ltd., Bristol-Myers Squibb Co., and Boehringer Ingelheim and scholarships from Medtronic Japan Co. Ltd, Daiichi Sankyo, Inc., Abbott Vascular Japan Co., Ltd., Boston Scientific Corp., Otsuka Pharmaceutical Co., Ltd., Pfizer Inc., Astellas Pharma Inc., Takeda Pharmaceutical Co., Ltd., Japan Lifeline Co., Ltd. The other authors declare no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. The data that support the study findings are available upon request from the corresponding author. The data are not publicly available because they contain identifying information of the research participants.
