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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1486621

Ethanol Marshall Bundle elimination, Pulmonary Vein Isolation, and Linear Ablation for Atrial Fibrillation with or without Heart Failure

Provisionally accepted
Hongxu Chen Hongxu Chen 1,2*Huahua Li Huahua Li 3Dan Chen Dan Chen 1Xiong Xiong Xiong Xiong 1Xi Li Xi Li 3Yanhong Chen Yanhong Chen 1,2,4*Jinlin Zhang Jinlin Zhang 1*
  • 1 Department of Cardiology, Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
  • 2 School of Medicine, Department of Medicine, Wuhan University of Science and Technology, Wuhan, China
  • 3 Department of Cardiology, Wuhan Asia General Hospital, Wuhan, China
  • 4 Division of Cardiac Arrhythmia, Cardiac and Vascular Center, The university of hong kong-Shenzhen hospital, Shenzhen, China

The final, formatted version of the article will be published soon.

    Background: In medical practice, atrial fibrillation (AF) is intricately associated with heart failure (HF). Currently, ethanol infusion of vein of Marshall (EIVOM) for AF ablation in HF patients remains significantly limited.This was a non-randomized, single-center, retrospective observational study.AF patients received 4-step ablation composed of EIVOM, pulmonary vein isolation (PVI) and linear ablation. The primary composite endpoint was defined as recurrence of atrial tachycardia over 30 seconds. Propensity score matching (PSM) was performed to reduce selection bias.Results: From April 2020 to May 2022, 362 patients were included, comprising of 182 HF patients and 180 non-HF patients. EIVOM success rate was lower in HF patients than non-HF patients (86.8% vs 93.9%). Cardiac effusion was more common in HF patients (44.0% vs 37.2%), and 2 cases of atrial-esophageal fistula were observed in the HF group. During a median follow-up of 12 months, no significant difference in the primary endpoint was observed between HF and non-HF group.Different HF subgroups had similar AF recurrence. After PSM, AF recurrence rate remained statistically equivalent between the HF and non-HF groups.EVIOM combining catheter ablation can be completed with comparable success rate in AF patients with or without HF. However, peri-procedural safety is a concern for HF patients undergoing EIVOM combing AF catheter ablation. During the follow-up, HF status before ablation is not related with increased AF recurrence.

    Keywords: Atrial Fibrillation, Heart Failure, Catheter Ablation, Vein of Marshall, Esophageal Fistula

    Received: 26 Aug 2024; Accepted: 13 Nov 2024.

    Copyright: © 2024 Chen, Li, Chen, Xiong, Li, Chen and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hongxu Chen, Department of Cardiology, Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
    Yanhong Chen, Department of Cardiology, Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
    Jinlin Zhang, Department of Cardiology, Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.