Efficiency and Durability of EIVOM on Acute Reconnection After Mitral Isthmus Bidirectional Block

医学 心脏病学 射频导管消融术 内科学 心房颤动 烧蚀 导管消融 肺静脉 块(置换群论) 射频消融术 麻醉 几何学 数学
作者
Song Zuo,Caihua Sang,Deyong Long,Xiaowen Bo,Yiwei Lai,Qi Guo,Yufeng Wang,Mengmeng Li,Liu He,Xin Zhao,Xueyuan Guo,Nian Liu,Songnan Li,Wei Wang,Chenxi Jiang,Ribo Tang,Xin Du,Jianzeng Dong,Changsheng Ma
出处
期刊:JACC: Clinical Electrophysiology [Elsevier BV]
卷期号:10 (4): 685-694 被引量:7
标识
DOI:10.1016/j.jacep.2023.11.027
摘要

Reconnection after mitral isthmus (MI) block with radiofrequency ablation is common. The aim of this study was to investigate the effects of ethanol infusion in the vein of Marshall (EIVOM) on acute reconnection after MI bidirectional block. Patients with persistent atrial fibrillation who were scheduled to receive radiofrequency ablation for the first time were randomly assigned to the radiofrequency catheter ablation (RFCA) group (n = 44) or the EIVOM group (n = 45). The RFCA group's strategy was bilateral pulmonary vein ablation and linear ablation; in the EIVOM group, EIVOM was performed first. The primary endpoint was acute reconnection 30 minutes after MI bidirectional block. A total of 89 patients (average age 62.9 years; 57.3% male) were enrolled. The average duration for persistent atrial fibrillation was 2.3 years. Before observation, all patients in the EIVOM group achieved MI bidirectional block (45 of 45 [100%]), compared with 84.1% (37 of 44) in the RFCA group. After the observation, 3 cases of MI reconnection occurred in the EIVOM group and 13 cases in the RFCA group (6.7% vs 35.1%; P < 0.05). After additional ablation, the final MI block rates in the EIVOM and RFCA groups were 97.8% (44 of 45) and 72.7% (32 of 44), respectively. During a 1-year follow-up, 8 of 45 patients who underwent EIVOM had recurrent atrial fibrillation, compared with 14 of 44 in the RFCA group (17.8% vs 31.8%; P < 0.01). EIVOM can reduce acute reconnection after MI bidirectional block and significantly increase first-pass MI block.
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