Vein of Marshall ethanol infusion in the treatment of atrial fibrillation: From concept to clinical practice

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2 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1074-1082
Number of pages9
JournalHeart Rhythm
Volume18
Issue number7
DOIs
StatePublished - Jul 2021

Keywords

  • Ablation
  • Alcohol
  • Atrial fibrillation
  • Ethanol
  • Vein of Marshall

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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