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Comparative Study
. 2025 Oct;68(7):1497-1500.
doi: 10.1007/s10840-024-01963-z. Epub 2024 Dec 5.

Acute mitral block: pulse field ablation plus radiofrequency ablation when compared to radiofrequency ablation plus ethanol injection of vein of Marshall

Alexander Cubberley  1 , Amir A Ahmadian-Tehrani  2 , Medhansh Kashyap  2 , Taylor Pickering  2 , Mustafa Dohadwala  3
Affiliations
Comparative Study

Acute mitral block: pulse field ablation plus radiofrequency ablation when compared to radiofrequency ablation plus ethanol injection of vein of Marshall

Alexander Cubberley et al. J Interv Card Electrophysiol. 2025 Oct.

Abstract

This retrospective study evaluated two groups: patients receiving RFA for PVI, posterior wall isolation, mitral isthmus, and coronary sinus (CS) ablation with adjunctive VOM ethanol injection (VOM/RFA ALL (N = 53)), and patients receiving PVI with PFA using pentaspline catheter followed by mitral isthmus and CS ablation with RFA (PFA PV + PW/RFA MITRAL (N = 12)). We hypothesized that PFA for pulmonary vein isolation (PVI) facilitates mitral block without adjunctive vein of Marshall (VOM) ethanol injection. Mitral block was achieved in 92.5% of VOM/RFA ALL patients and 83.3% of the PFA PV + PW/RFA MITRAL group (p = 0.31). Endocardial ablation time of the mitral isthmus and RF applications required to achieve a complete block were significantly shorter in the VOM/RFA ALL group (208 s vs 356 s, p < 0.01 and 14.5 vs 24.0, p < 0.01, respectively). Adjunctive VOM ethanol injection appears to still have a role for facilitation of mitral isthmus block in the new era of PFA.

Keywords: Persistent atrial fibrillation; Pulsed field ablation; Vein of Marshall ethanol ablation.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

References

    1. Valderrábano M, Peterson LE, Swarup V, Schurmann PA, Makkar A, Doshi RN, et al. Effect of catheter ablation with vein of Marshall ethanol infusion vs catheter ablation alone on persistent atrial fibrillation: the VENUS randomized clinical trial. JAMA. 2020;324:1620–8. https://doi.org/10.1001/JAMA.2020.16195 . - DOI - PubMed
    1. Wahid T, Khan H, Dohadwala MM. Ten steps in adoption of emerging procedural techniques: an experience with ethanol ablation of vein of Marshall (VOM). Cureus 2022;14. https://doi.org/10.7759/CUREUS.24948 .
    1. Davong B, Adeliño R, Delasnerie H, Albenque JP, Combes N, Cardin C, et al. Pulsed-field ablation on mitral isthmus in persistent atrial fibrillation: preliminary data on efficacy and safety. JACC Clin Electrophysiol. 2023;9:1070–81. https://doi.org/10.1016/J.JACEP.2023.03.021 . - DOI - PubMed
    1. Higuchi S, Il Im S, Stillson C, Buck ED, Jerrell S, Schneider CW, et al. Effect of epicardial pulsed field ablation directly on coronary arteries. JACC Clin Electrophysiol. 2022;8:1486–96. https://doi.org/10.1016/J.JACEP.2022.09.003 . - DOI - PubMed
    1. Malyshev Y, Neuzil P, Petru J, Funasako M, Hala P, Kopriva K, et al. Does acute coronary spasm from pulsed field ablation translate into chronic coronary arterial lesions? JACC Clin Electrophysiol. 2024;10:970–2. https://doi.org/10.1016/J.JACEP.2024.01.007 . - DOI - PubMed

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