Application value of anhydrous ethanol ablation of Marshall vein in patients with persistent atrial fibrillation
LI Zhenhui
MA Yongjiang
GUO Mate
ZHANG Chunhong
ZHANG Liwei
Abstract：Objective To investigate the safety and efficacy of anhydrous ethanol chemical ablation of the vein of Marshall(VOM)combined with radiofrequency catheter ablation(RFCA)of 2C3L[2C:bilateral circumferential pulmonary-vein ablation(CPVA);3L:left atrial roof line,mitral valve isthmus(MVI),tricuspid isthmus line]in patients with persistent atrial fibrillation(PeAF).Methods PeAF patients(n=22)were selected and divided into group A(with anhydrous ethanol ablation)and group B(without anhydrous ethanol ablation,n=11)in the Fourth Medical Center of Chinese PLA General Hospital from Nov.2021 to Aug.2023.Group A was treated with anhydrous ethanol ablation of VOM combined with 2C3L procedure,and group B was only treated with routine 2C3L procedure.After both groups were converted to sinus rhythm,the achievement of surgical endpoints was evaluated by verifying pulmonary vein isolation and whether each ablation line was blocked.The clinical success rate(defined as no AF recurrence within 1 y of follow-up after a single ablation)and surgical safety were discussed in patients who underwent anhydrous ethanol ablation of VOM combined with 2C3L procedure.Results Except for the CHA2DS2-VaSc-60 score,there were no statistically significant differences in other baseline data between the two groups of patients(P>0.05).In group A,the success rate of ethanol ablation of the Marshall vein during the operation was 100%,and the termination rate of atrial fibrillation ablation during the operation was 100%in both groups.The surgical success rate of no AF recurrence within 1 y after a single ablation in group A was higher than that in group B(81.82%vs.54.55%).None of the patients had complications such as esophageal-atrial fistula,cardiac tamponade,pulmonary vein stenosis,or vascular puncture-related complications during or after the procedure.Conclusion anhydrous ethanol ablation of VOM combined with 2C3L procedure is safety and feasible in PeAF treatment.
Keywords：persistent atrial fibrillationmarshall veinanhydrous ethanolradiofrequency catheter ablationchemical ablation
Publication Date：2025-10-20
Online Publishing Date：2025-12-03(First online date of this platform, not the publication date of the document)
Pages：5( 1248-1252 )