Ethanol infusion for Marshall bundle epicardial connections in Marshall bundle-related atrial tachycardias following atrial fibrillation ablation: The accessibility and success rate of ethanol infusion by using a femoral approach.

Kitamura, Takeshi; Vlachos, Konstantinos; Denis, Arnaud; Andre, Clementine; Martin, Ruairidh; Pambrun, Thomas; Duchateau, Josselin; Frontera, Antonio; Takigawa, Masateru; Thompson, Nathaniel; Cheniti, Ghassen; Martin, Claire A; Lam, Anna; Bourier, Felix; Sacher, Frederic; Hocini, Meleze; Haissaguerre, Michel; Jais, Pierre; Derval, Nicolas

doi:10.1111/jce.14019

2019

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Document type:: Article; Journal Article; Observational Study
Author(s):: Kitamura, Takeshi; Vlachos, Konstantinos; Denis, Arnaud; Andre, Clementine; Martin, Ruairidh; Pambrun, Thomas; Duchateau, Josselin; Frontera, Antonio; Takigawa, Masateru; Thompson, Nathaniel; Cheniti, Ghassen; Martin, Claire A; Lam, Anna; Bourier, Felix; Sacher, Frederic; Hocini, Meleze; Haissaguerre, Michel; Jais, Pierre; Derval, Nicolas
Title:: Ethanol infusion for Marshall bundle epicardial connections in Marshall bundle-related atrial tachycardias following atrial fibrillation ablation: The accessibility and success rate of ethanol infusion by using a femoral approach.
Abstract:: BACKGROUND: Ethanol infusion of the vein of Marshall (VOM) may be effective to treat Marshall bundle-related atrial tachycardia (MB-AT). However, methods and clinical results of ethanol infusion for MB-AT have been not established. OBJECTIVE: To assess the accessibility of the VOM and the success rate of ethanol infusion using a femoral approach for MB-AT. METHODS: A single-center observational study included consecutive patients who had MB-AT and in whom we attempted to treat MB-AT during AT by ethanol infusion. When the VOM was able to be cannulated following VOM venogram using a femoral approach, we systematically performed ethanol infusion with selective balloon occlusion of the VOM. We analyzed in detail the efficacy of ethanol infusion of VOM in patients who were in MB-AT during ethanol infusion. RESULTS: We enrolled 54 consecutive patients in whom we attempted to treat MB-AT by ethanol infusion. Of those, the VOM was accessible in 92.5% of patients (50 of 54). Of the 50 patients treated by ethanol infusion during MB-AT, AT was successfully terminated in 56% percent of the patients (28 of 50) by solo treatment of ethanol infusion without RF ablation. The remainder required additional RF application to terminate the MB-AT. A mean of 6.2 ± 2.8 mL of ethanol was infused resulting in the low-voltage area significantly larger than that before ethanol infusion (12.7 ± 8.3 vs 6.6 ± 5.3 cm2 , P < .001). CONCLUSION: The present study demonstrated that the VOM was highly accessible and MB-AT was amenable to treatment by ethanol infusion by using a femoral approach.
Journal title abbreviation:: J Cardiovasc Electrophysiol
Year:: 2019
Journal volume:: 30
Journal issue:: 9
Pages contribution:: 1443-1451
Fulltext / DOI:: doi:10.1111/jce.14019
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/31187516
Print-ISSN:: 1045-3873
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2019