Abstract 17470: The Effectiveness of Ethanol Infusion in the Vein of Marshall for Bidirectional Mitral Isthmus Block in Unsuccessful Cases With Conventional Ablation
2015 AHA Effectiveness of Ethanol Infusion in the Vein of Marshall for Bidirectional Mitral Isthmus Block in Unsuccessful Cases with Conventional Ablation
[Introduction] Treatment of mitral isthmus dependent atrial tachycardia (AT) requires bidirectional mitral isthmus (MI) block. It is usually difficult to achieve bidirectional MI block by endocardial linear ablation. When MI block is incomplete, additional ablation inside the coronary sinus (CS) is often required. The vein of Marshall (VOM) is located in the epicardial aspect of MI. The purpose of this study is to determine whether complete bidirectional MI block is obtained by ethanol infusion in the VOM in cases with incomplete MI block by conventional ablation.
[Method] This study consisted of 38 consecutive patients who underwent conventional ablation to obtain bidirectional MI block from October 2013 to September 2014.
[Results] In 24 patients (63%), bidirectional MI block was achieved by conventional ablation. In 11 patients (29%) of the other 14 patients, the CS venogram was performed to assess the presence or absence of the VOM. The VOM was imaged in 9 patients (24%), into which 100% ethanol was injected (2ml, 2-3times). After ethanol infusion in the VOM, bidirectional MI block was obtained in all cases (Figure).
[Conclusion] Ethanol infusion in the VOM is an effective treatment in cases with incomplete MI block by conventional ablation.
Author Disclosures: K. Hirai: None. H. Fujimoto: None. M. Naito: None. H. Yano: None. T. Kosugi: None. Y. Hashimoto: None. T. Isojima: None. M. Suzuki: None. H. Iwama: None. T. Nakai: None. N. Doi: None.
- © 2015 by American Heart Association, Inc.