Ethanol infusion in the vein of Marshall facilitates mitral isthmus ablation.
Ethanol infusion in the vein of Marshall facilitates mitral isthmus ablation.
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DOI：
10.1016/j.hrthm.2012.03.008
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发表时间：
2012-08
期刊：
影响因子：
5.5
通讯作者：
Valderrábano M
中科院分区：
文献类型：
--
作者：
Báez-Escudero JL;Morales PF;Dave AS;Sasaridis CM;Kim YH;Okishige K;Valderrábano M
治疗二尖瓣周围扑动（PMF）需要双向二尖瓣峡部（MI）阻断，这可能很难与射频消融（RFA）。马歇尔静脉（VOM）位于心肌梗死内，检测VOM乙醇输注是否有助于心肌梗死阻滞。研究心房颤动（AF）消融患者的膜周传导。第1组包括50例既往房颤消融的重复消融患者，其中30例曾行心梗消融。自发PMF（8/50）或诱导PMF（21/50）通过激活作图证实。第二组21例患者接受VOM乙醇输注。VOM用四极导管进行起搏，并用血管成形术球囊输送多达四次1mL的98%乙醇。绘制了VOM乙醇前后的电压图。通过差分起搏验证双向心肌梗死阻滞。评估了实现该目标所需的RFA时间。在第一组中，VOM乙醇输注急性终止PMF的患者有5/29。RFA达到双向MI阻断所需时间为2.2±1.6 min。PMF的存在或既往心肌梗死消融不影响RFA时间。2组RFA达到双向心肌梗死阻断所需时间为2.0±1.6 min （p=NS）。5例患者仅通过VOM乙醇实现双向心肌梗死阻断，而不使用RFA。两组患者均需在心肌梗死环状部位行VOM乙醇消融，无急性并发症。VOM乙醇输注在PMF治疗中是有用的，并有助于可靠地实现双向心肌梗死阻断。
Treatment of perimitral flutter (PMF) requires bidirectional mitral isthmus (MI) block, which can be difficult with radiofrequency ablation (RFA). The vein of Marshall (VOM) is located within the MI. To test whether VOM ethanol infusion could help achieve MI block. Perimitral conduction was studied in patients undergoing ablation of atrial fibrillation (AF). Group 1 included 50 patients with a previous AF ablation undergoing repeat ablation, 30 of which had had MI ablation. Spontaneous (8/50) or inducible PMF (21/50) was confirmed by activation mapping. Group 2 included 21 patients undergoing de novo VOM ethanol infusion. The VOM was cannulated with a quadripolar catheter for pacing and with an angioplasty balloon to deliver up to four 1mL infusions of 98% ethanol. Voltage maps were created before and after VOM ethanol. Bidirectional MI block was verified by differential pacing. RFA times required to achieve it were assessed. In Group 1, VOM ethanol infusion acutely terminated PMF in 5/29 patients. RFA needed to achieve bidirectional MI block was 2.2±1.6 min. Presence of PMF or previous MI ablation did not affect RFA times. In Group 2, RFA needed to achieve bidirectional MI block was 2.0±1.6 min (p=NS). Five patients had bidirectional MI block achieved solely by VOM ethanol without RFA. In both groups, ablation after VOM ethanol was required in the annular aspect of the MI. There were no acute complications. VOM ethanol infusion is useful in the treatment of PMF and assists in reliably achieving bidirectional MI block.
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影响因子：
6.1
作者：
Deisenhofer, Isabel;Estner, Heidi;Schmitt, Claus
通讯作者：
Schmitt, Claus
影响因子：
8.4
作者：
Ammar, Sonia;Hessling, Gabriele;Deisenhofer, Isabel
通讯作者：
Deisenhofer, Isabel
DOI：
10.1111/j.1540-8167.2011.02112.x
发表时间：
2011-12-01
影响因子：
2.7
作者：
Matsuo, Seiichiro;Yamane, Teiichi;Yoshimura, Michihiro
通讯作者：
Yoshimura, Michihiro
影响因子：
37.8
作者：
Pappone, C;Manguso, F;Santinelli, V
通讯作者：
Santinelli, V
影响因子：
37.8
作者：
Jaïs, P;Hocini, M;Haïssaguerre, M
通讯作者：
Haïssaguerre, M