Use of intracardiac echocardiography in vein of Marshall ethanol infusion for ablation of persistent atrial fibrillation

作者全名："Ding, Xueyan; Wang, Li; Liu, Qiang; Chen, Shiquan; Jiang, Ruhong; Yu, Lu; Zhang, Pei; Lin, Jianwei; Sun, Yaxun; Sheng, Xia; Fu, Guosheng; Zei, Paul C.; Jiang, Chenyang"

作者地址："[Ding, Xueyan; Liu, Qiang; Chen, Shiquan; Jiang, Ruhong; Yu, Lu; Zhang, Pei; Lin, Jianwei; Sun, Yaxun; Sheng, Xia; Fu, Guosheng; Jiang, Chenyang] Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Dept Cardiol, Hangzhou, Zhejiang, Peoples R China; [Wang, Li] Chongqing Med Univ, Dept Cardiol, Yongchuan Hosp, Chongqing, Peoples R China; [Zei, Paul C.] Brigham & Womens Hosp, Dept Cardiac Electrophysiol & Cardiovasc Med, Boston, MA USA; [Jiang, Chenyang] Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Dept Cardiol, 3 East Qingchun Rd, Hangzhou, Zhejiang, Peoples R China"

通信作者："Jiang, CY (通讯作者)，Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Dept Cardiol, 3 East Qingchun Rd, Hangzhou, Zhejiang, Peoples R China."

来源：HEART RHYTHM

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001195984700001

JCR分区：Q1

影响因子：5.5

年份：2024

卷号：21

期号：3

开始页：274

结束页：281

文献类型：Article

关键词：VOM ethanol infusion; Consistent echogenic streaming; Ridge; Myocardial local echogenicity; Intracardiac echo- cardiography; Persistent atrial fibrillation

摘要：Background Few methods have been reported to demonstrate real-time effects during vein of Marshall (VOM) ethanol infusion in persistent atrial fibrillation (PeAF). Objective This study was to evaluate the impact of left atrial (LA) monitoring using intracardiac echocardiography (ICE) during VOM ethanol infusion. Methods Seventy-four consecutive patients with PeAF who underwent VOM ethanol infusion followed by radiofrequency (RF) ablation were included. Patients with findings on ICE consistent with echogenic streaming in the LA and with increased myocardial local echogenicity along the VOM area were placed into one group (group A) and those without into the other group (group B). Outcomes between the 2 groups were compared. Results Forty-six patients (62%) were placed into group A. A new ethanol-induced low-voltage area in group A was larger than that in group B (8.5 cm(2) [5.5-10.2 cm(2)] and 4.0 cm(2) (2.4-6.3 cm(2)]; P < .001). The RF ablation time required to achieve MI block was reduced in group A patients (263.0 seconds [196.0-351.0 seconds] vs 417.0 seconds [315.0-709.5 seconds] in group B patients; P < .001). MI block was achieved in 46 patients (100%) via an endocardial approach in group A and 27 patients (96.4%) in group B (extra coronary sinus ablation in 4 patients). One patient developed clinically significant pericardial effusions and required pericardiocentesis in group B. Conclusion Presence of increased myocardial local echogenicity at the ridge and consistent echogenic streaming in the LA detected by ICE-based imaging during VOM ethanol infusion suggests increased ablated tissue in that region and lower RF ablation time during ablation for PeAF.

基金机构：Health Commission of Zhejiang Province [2022KY508]

基金资助正文：Funding Sources: This work was supported by the Health Commission of Zhejiang Province (project no. 2022KY508) .