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Long-term effects of catheter ablation with vein of Marshall ethanol infusion vs. pulmonary vein isolation alone on persistent atrial fibrillation

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机构： [1]Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China. [2]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. [3]Department of Cardiology, East Branch, The Second Hospital of Hebei Medical University, Shijiazhuang, China. [4]State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. [5]Department of Cardiology, Beijing Oriental Hospital, Beijing University of Traditional Chinese Medicine, Beijing, China.

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关键词： Persistent atrial fibrillation Pulmonary vein isolation Ethanol infusion Marshall vein ablation Long-term effects Recurrence

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To evaluate the safety, efficacy, and long-term effects of catheter ablation with vein of Marshall ethanol infusion for bidirectional mitral isthmus block in patients with persistent atrial fibrillation.Two hundred and forty patients from five centers with persistent atrial fibrillation (AF) who underwent radiofrequency ablation from October 2018 to December 2023 were retrospectively analyzed, including 120 patients who underwent traditional pulmonary vein isolation (PVI Only group) and 120 patients who underwent PVI and Marshall vein ablation (Marshall Plus group). The operation time, X-ray exposure, incidence of AF/atrial tachycardia (AT) and complications were compared between the two groups.Among the 240 patients (mean age: 57.2 ± 7.2 years, males: 195/240, 81.25 %), vein of Marshall ethanol infusion was successfully performed in 113 of 120 patients. At 12 and 36 months, the proportion of patients free from AF/ AT after a single procedure was 76.3 % (90/118) in the PVI plus vein of Marshall ethanol infusion group and 67.5 % (79/117) in the PVI only group (P < 0.01). Perimitral block was successfully achieved in 90.8 % (109/120) patients in the Marshall Plus group. Freedom from AF/AT at the 3-year follow-up (68.6 % vs. 59.8 %, P < 0.01) and incidence of adverse events were similar between the two groups.PVI combined with Marshall venous infusion ablation can safely and effectively increase the long-term success rate of AF ablation. Duration of AF, left atrial volume(>42 mm,)and bidirectional mitral isthmus block were associated with recurrence of AF/AT.Copyright © 2025. Published by Elsevier B.V.

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出版当年[2025]版：

大类 | 2 区医学

小类 | 3 区心脏和心血管系统

最新[2025]版：

大类 | 2 区医学

小类 | 3 区心脏和心血管系统

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第一作者机构： [1]Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

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