Acute and mid-term outcome of ethanol infusion of vein of Marshall for the treatment of perimitral flutter
| Autor: | Yosuke Nakatani, Hubert Cochet, Michel Haïssaguerre, Masateru Takigawa, William Escande, Anna Lam, Mélèze Hocini, Daniel Ramirez, Nathaniel Thompson, Xavier Pillois, Nicolas Derval, Takeshi Kitamura, Arnaud Denis, Frederic Sacher, Li-jun Zeng, Michael Wolf, Clémentine André, Thomas Pambrun, Claire A. Martin, Josselin Duchateau, Felix Bourier, Grégoire Massoullié, Antonio Frontera, Pierre Jaïs, Ghassen Cheniti, Ruairidh Martin, Konstantinos Vlachos, Takashi Nakashima |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Catheter ablation Pericardial effusion Brain Ischemia Physiology (medical) Internal medicine Infusion Procedure Atrial Fibrillation Ischaemic stroke medicine Humans Vein Atrial tachycardia Ethanol business.industry Ablation medicine.disease Stroke Treatment Outcome medicine.anatomical_structure Perimitral flutter Atrial Flutter Catheter Ablation Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | EP Europace. 22:1252-1260 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/euaa137 |
| Popis: | Aims 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). Methods and results 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 Conclusion 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. |
| Databáze: | OpenAIRE |
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