Multitechnique approach for peri-mitral flutter: A case report of combining direct vein of Marshall ethanol infusion and alpha loop ablation.

ABSTRACT: The management of peri-mitral flutter often necessitates a vein of Marshall (VOM) ethanol infusion (EI) and radiofrequency ablation within the coronary sinus (CS). These procedures can be technically demanding due to the anatomical constraints and require a nuanced understanding of catheter techniques. We report a patient who experienced dual tachycardias involving a peri-mitral flutter and roof-dependent atrial tachycardia after cryoballoon pulmonary vein isolation. Since linear ablation of the lateral mitral isthmus failed to eliminate the tachycardia, the involvement of epicardial structures such as the VOM and CS was suggested. Attempts at a VOM-EI using a catheter with a lumen succeeded in delivering ethanol but failed to terminate the arrhythmia. Standard techniques for catheter inse

SUBMITTER: Fukushima T 

PROVIDER: S-EPMC12432514 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature