Premium
Chemical mapping as a predictor of vein of Marshall ethanol ablative effects
Author(s) -
Okishige Kaoru,
Shigeta Takatoshi,
Nishimura Takuro,
Nakamura Rena A.,
Hirao Tatsuhiko,
Yoshida Hiroshi,
Yamauchi Yasuteru,
Keida Takehiko,
Sasano Tetsuo,
Hirao Kenzo,
Valderrábano Miguel
Publication year - 2020
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13839
Subject(s) - medicine , ablative case , atrial fibrillation , ethanol , cardiology , ablation , lesion , balloon , catheter , catheter ablation , anesthesia , surgery , chemistry , organic chemistry , radiation therapy
Purpose The aim of this study was to test regional pharmacological effects of an antiarrhythmic agents to predict ablative effects. Background The vein of Marshall (VOM) providing vascular access to myocardial tissue has been used for ablative purposes using ethanol. Methods A total of 35 patients (male 21, 63.2 ± 7.8 years old) were included. A balloon‐tipped infusion catheter was inserted into the VOM. Endocardial ultrahigh‐resolution mapping was performed along the VOM region to record the change in atrial electrograms (AEs) after VOM injection of cibenzoline of 3.5 mg during sustained atrial fibrillation (AF). Subsequently, ethanol was infused into the VOM and ablative region was mapped. Results In 17 patients (49 %), cibenzoline reduced AEs amplitude by >50%, all of which had also complete elimination of AEs following ethanol (Group A). In 18 patients (Group B), cibenzoline failed to eliminate AEs; yet, in 13 of 18 AEs were eliminated by ethanol. In the remaining five patients, ethanol did not eliminate AE. Conclusions Cibenzoline into the VOM could reliably predicts the results of subsequent ethanol infusion into the VOM using ultrahigh‐resolution mapping system, which leads to avoid unnecessary permanent lesion creation by ethanol infusion.