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Anatomical Treatment Strategies for Persistent Atrial Fibrillation with Ethanol Infusion within the Vein of Marshall—Current Challenges and Future Directions

by Haïssaguerre, Michel , Bouyer, Benjamin , Mené, Roberto , Buliard, Samuel , Hocini, Mélèze , Pambrun, Thomas , Ogbedeh, Chizute , Popa, Miruna , Vlachos, Konstantinos , Jaïs, Pierre , Kneizeh, Kinan , Duchateau, Josselin , Benali, Karim , Arnaud, Marine , Ascione, Ciro , Chauvel, Rémi , Sacher, Frédéric , Derval, Nicolas , Kowalewski, Christopher , Yokoyama, Masaaki , Tixier, Romain , Monaco, Cinzia

in Ablation / Ablation (Surgery) / Atrial fibrillation / Body fat / Cardiac arrhythmia / Care and treatment / Catheters / Development and progression / Diagnosis / Evaluation / Forecasts and trends / Life Sciences / Ligaments / Patient outcomes / Review / Santé publique et épidémiologie

2024

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Anatomical Treatment Strategies for Persistent Atrial Fibrillation with Ethanol Infusion within the Vein of Marshall—Current Challenges and Future Directions

2024

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Anatomical Treatment Strategies for Persistent Atrial Fibrillation with Ethanol Infusion within the Vein of Marshall—Current Challenges and Future Directions

2024

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Journal Article

Anatomical Treatment Strategies for Persistent Atrial Fibrillation with Ethanol Infusion within the Vein of Marshall—Current Challenges and Future Directions

Haïssaguerre, Michel,

Bouyer, Benjamin,

Mené, Roberto,

Buliard, Samuel,

Hocini, Mélèze,

Pambrun, Thomas,

Ogbedeh, Chizute,

Popa, Miruna,

Vlachos, Konstantinos,

Jaïs, Pierre,

Kneizeh, Kinan,

Duchateau, Josselin,

Benali, Karim,

Arnaud, Marine,

Ascione, Ciro,

Chauvel, Rémi,

Sacher, Frédéric,

Derval, Nicolas,

Kowalewski, Christopher,

Yokoyama, Masaaki,

Tixier, Romain,

Monaco, Cinzia

2024

Overview

Currently, pulmonary vein isolation (PVI) is the gold standard in catheter ablation for atrial fibrillation (AF). However, PVI alone may be insufficient in the management of persistent AF, and complementary methods are being explored. One such method takes an anatomical approach—improving both its success rate and lesion durability may lead to improved treatment outcomes. An additional approach complementary to the anatomical one is also attracting attention, one that focuses on epicardial conduction. This involves ethanol ablation of the vein of Marshall (VOM) and can be very effective in blocking epicardial conduction related to Marshall structure; it is becoming incorporated into standard treatment. However, the pitfall of this “Marshall-PLAN”, a method that combines an anatomical approach with ethanol infusion within the VOM (Et-VOM), is that Et-VOM and other line creations are not always successfully completed. This has led to cases of AF and/or atrial tachycardia (AT) recurrence even after completing this lesion set. Investigating effective adjunctive methods will enable us to complete the lesion set with the aim to lower the rates of recurrence of AF and/or AT in the future.

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Publisher

MDPI AG,MDPI

Subject

Ablation

/ Ablation (Surgery)

/ Atrial fibrillation