TY - JOUR
T1 - Vein of Marshall ethanol infusion in the treatment of atrial fibrillation
T2 - From concept to clinical practice
AU - Valderrábano, Miguel
N1 - Funding Information:
Funding sources: This work was funded by the National Institutes of Health /National Heart, Lung, and Blood Institute (NIH/NHLBI) Grants R21HL097305 and R01 HL1150030; the Lois and Carl Davis Centennial Chair; and the Charles Burnett III endowments. Disclosures: The author has no conflicts of interest to disclose.
Publisher Copyright:
© 2021 Heart Rhythm Society
PY - 2021/7
Y1 - 2021/7
N2 - The vein of Marshall (VOM) contains innervation, myocardial connections, and arrhythmogenic foci that make it an attractive target in catheter ablation of atrial fibrillation (AF). Additionally, it co-localizes with the mitral isthmus, which is critical to sustain perimitral flutter, and is a true atrial vein that communicates with underlying myocardium. Retrograde balloon cannulation of the VOM from the coronary sinus is feasible and allows for ethanol delivery, which results in rapid ablation of neighboring myocardium and its innervation. Here we review the body of work performed over a span of 13 years, from the inception of the technique, to its preclinical validation, to demonstration of its ablative and denervation effects, and finally to completion of a randomized clinical trial demonstrating favorable outcomes, improving rhythm control in catheter ablation of persistent AF.
AB - The vein of Marshall (VOM) contains innervation, myocardial connections, and arrhythmogenic foci that make it an attractive target in catheter ablation of atrial fibrillation (AF). Additionally, it co-localizes with the mitral isthmus, which is critical to sustain perimitral flutter, and is a true atrial vein that communicates with underlying myocardium. Retrograde balloon cannulation of the VOM from the coronary sinus is feasible and allows for ethanol delivery, which results in rapid ablation of neighboring myocardium and its innervation. Here we review the body of work performed over a span of 13 years, from the inception of the technique, to its preclinical validation, to demonstration of its ablative and denervation effects, and finally to completion of a randomized clinical trial demonstrating favorable outcomes, improving rhythm control in catheter ablation of persistent AF.
KW - Ablation
KW - Alcohol
KW - Atrial fibrillation
KW - Ethanol
KW - Vein of Marshall
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U2 - 10.1016/j.hrthm.2021.03.032
DO - 10.1016/j.hrthm.2021.03.032
M3 - Article
C2 - 33781979
SN - 1547-5271
VL - 18
SP - 1074
EP - 1082
JO - Heart Rhythm
JF - Heart Rhythm
IS - 7
ER -