Ethanol Infusion in the Vein of Marshall: Adjunctive Effects during Ablation of Atrial Fibrillation
| Autor: | Stephen H. Little, Jasvinder S. Sidhu, Xiushi Liu, Christine M. Sasaridis, Dirar S. Khoury, Miguel Valderrábano |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment Ablation of atrial fibrillation Catheter ablation Article Pulmonary vein law.invention Coronary circulation law Physiology (medical) Angioplasty Internal medicine Coronary Circulation Atrial Fibrillation medicine Humans Heart Atria Infusions Intravenous Ethanol business.industry Atrial fibrillation Middle Aged medicine.disease Ablation Combined Modality Therapy medicine.anatomical_structure Treatment Outcome Anesthesia Case-Control Studies Cardiology Catheter Ablation Female Cardiology and Cardiovascular Medicine business |
| Popis: | Background The vein of Marshall (VOM) is a left atrial (LA) vein that contains autonomic innervation and triggers of AF. Its location coincides with areas usually ablated during pulmonary vein (PV) antral isolation (PVAI). Objective This study sought to delineate the safety and ablative effects of ethanol infusion in the VOM during catheter ablation of atrial fibrillation (AF). Methods Patients undergoing PVAI (n = 14) gave consent for adjunctive VOM ethanol infusion. In 10 of 14 patients, the VOM was cannulated with an angioplasty wire and balloon. Echocardiographic contrast was injected in the VOM under echocardiographic monitoring. Two infusions of 100% ethanol (1 ml each) were delivered via the angioplasty balloon in the VOM. LA bipolar voltage maps were created before and after ethanol infusion. Radiofrequency ablation times required to isolate each PV and other procedural data were compared with those of 10 age-, sex-, AF type– and LA size–matched control subjects undergoing conventional PVAI. Results The VOM communicated with underlying myocardium, as shown by echocardiographic contrast passage into the LA. There were no acute complications related to VOM ethanol infusion, which led to the creation of a low-voltage area in the LA measuring 10.6 ± 7.6 cm 2 and isolation of the left inferior PV in 4 of 10 patients. Radiofrequency ablation time required to achieve isolation of the left inferior PV was reduced (2.2 ± 4 min vs. 11.4 ± 10.3 min in control subjects, P Conclusion VOM ethanol infusion is safe in humans, decreases radiofrequency ablation time in the left inferior PV, and may have a role as an adjunct to PVAI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|