Postablation Peri-Mitral Flutter Terminated by Vein of Marshall Ethanol Infusion and Extra Epicardial Ablation.

ABSTRACT:

Background

Ethanol infusion into the vein of Marshall (EIVOM), combined with radiofrequency catheter ablation, has been shown to facilitate atrial fibrillation management and achieve bidirectional mitral isthmus (MI) block. However, the anatomic variations of vein of Marshall (VOM) may influence procedural efficacy and should be considered.

Case summary

A 59-year-old man with persistent atrial fibrillation underwent radiofrequency catheter ablation with the 2C3L (pulmonary vein isolation and linear ablations across the mitral isthmus, left atrial rooftop, and cavotricuspid isthmus) strategy. Despite adequate endocardial ablation and conventional epicardial ablation via the coronary sinus, recurrent peri-mitral flutter developed. EIVOM was subsequently attempted to reinforce

SUBMITTER: Zheng X 

PROVIDER: S-EPMC12859615 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature