Abstract：
BACKGROUND: Reconnection after mitral isthmus (MI) block with radiofrequency ablation is common.
OBJECTIVE: The aim of this study was to investigate the effects of ethanol infusion in the vein of Marshall (EIVOM) on acute reconnection after MI bidirectional block.
METHODS: Patients with persistent atrial fibrillation who were scheduled to receive radiofrequency ablation for the first time were randomly assigned to the radiofrequency catheter ablation (RFCA) group (n = 44) or the EIVOM group (n = 45). The RFCA group\'s strategy was bilateral pulmonary vein ablation and linear ablation; in the EIVOM group, EIVOM was performed first. The primary endpoint was acute reconnection 30 minutes after MI bidirectional block.
RESULTS: A total of 89 patients (average age 62.9 years; 57.3% male) were enrolled. The average duration for persistent atrial fibrillation was 2.3 years. Before observation, all patients in the EIVOM group achieved MI bidirectional block (45 of 45 [100%]), compared with 84.1% (37 of 44) in the RFCA group. After the observation, 3 cases of MI reconnection occurred in the EIVOM group and 13 cases in the RFCA group (6.7% vs 35.1%; P < 0.05). After additional ablation, the final MI block rates in the EIVOM and RFCA groups were 97.8% (44 of 45) and 72.7% (32 of 44), respectively. During a 1-year follow-up, 8 of 45 patients who underwent EIVOM had recurrent atrial fibrillation, compared with 14 of 44 in the RFCA group (17.8% vs 31.8%; P < 0.01).
CONCLUSIONS: EIVOM can reduce acute reconnection after MI bidirectional block and significantly increase first-pass MI block.
OBJECTIVE: The aim of this study was to investigate the effects of ethanol infusion in the vein of Marshall (EIVOM) on acute reconnection after MI bidirectional block.
METHODS: Patients with persistent atrial fibrillation who were scheduled to receive radiofrequency ablation for the first time were randomly assigned to the radiofrequency catheter ablation (RFCA) group (n = 44) or the EIVOM group (n = 45). The RFCA group\'s strategy was bilateral pulmonary vein ablation and linear ablation; in the EIVOM group, EIVOM was performed first. The primary endpoint was acute reconnection 30 minutes after MI bidirectional block.
RESULTS: A total of 89 patients (average age 62.9 years; 57.3% male) were enrolled. The average duration for persistent atrial fibrillation was 2.3 years. Before observation, all patients in the EIVOM group achieved MI bidirectional block (45 of 45 [100%]), compared with 84.1% (37 of 44) in the RFCA group. After the observation, 3 cases of MI reconnection occurred in the EIVOM group and 13 cases in the RFCA group (6.7% vs 35.1%; P < 0.05). After additional ablation, the final MI block rates in the EIVOM and RFCA groups were 97.8% (44 of 45) and 72.7% (32 of 44), respectively. During a 1-year follow-up, 8 of 45 patients who underwent EIVOM had recurrent atrial fibrillation, compared with 14 of 44 in the RFCA group (17.8% vs 31.8%; P < 0.01).
CONCLUSIONS: EIVOM can reduce acute reconnection after MI bidirectional block and significantly increase first-pass MI block.
摘要：
背景：二尖瓣峡部（MI）阻断射频消融后的重新连接很常见。
目的：本研究的目的是研究Marshall静脉输注乙醇（EIVOM）对MI双向阻滞后急性再连接的影响。
方法：首次接受射频消融术的持续性心房颤动患者被随机分配到射频导管消融术（RFCA）组（n=44）或EIVOM组（n=45）。RFCA组的策略是双侧肺静脉消融和线性消融；在EIVOM组中，首先进行了EIVOM。主要终点是MI双向阻滞后30分钟的急性再连接。
结果：共纳入89例患者（平均年龄62.9岁；57.3%为男性）。持续性心房颤动的平均持续时间为2.3年。在观察之前,EIVOM组的所有患者均达到MI双向阻滞（45/45[100%]），与RFCA组的84.1%(44个中的37个)相比。在观察之后,EIVOM组发生MI再连接3例,RFCA组发生MI再连接13例(6.7%vs35.1%;P<0.05)。额外消融后,EIVOM和RFCA组的最终MI阻滞率为97.8%(45个中的44个)和72.7%(44个中的32个)，分别。在为期一年的随访中，45例接受EIVOM的患者中有8例反复房颤，RFCA组44人中有14人(17.8%vs31.8%；P<0.01)。
结论：EIVOM可减少MI双向传导阻滞后的急性再连接，并显着增加首次通过MI传导阻滞。
目的：本研究的目的是研究Marshall静脉输注乙醇（EIVOM）对MI双向阻滞后急性再连接的影响。
方法：首次接受射频消融术的持续性心房颤动患者被随机分配到射频导管消融术（RFCA）组（n=44）或EIVOM组（n=45）。RFCA组的策略是双侧肺静脉消融和线性消融；在EIVOM组中，首先进行了EIVOM。主要终点是MI双向阻滞后30分钟的急性再连接。
结果：共纳入89例患者（平均年龄62.9岁；57.3%为男性）。持续性心房颤动的平均持续时间为2.3年。在观察之前,EIVOM组的所有患者均达到MI双向阻滞（45/45[100%]），与RFCA组的84.1%(44个中的37个)相比。在观察之后,EIVOM组发生MI再连接3例,RFCA组发生MI再连接13例(6.7%vs35.1%;P<0.05)。额外消融后,EIVOM和RFCA组的最终MI阻滞率为97.8%(45个中的44个)和72.7%(44个中的32个)，分别。在为期一年的随访中，45例接受EIVOM的患者中有8例反复房颤，RFCA组44人中有14人(17.8%vs31.8%；P<0.01)。
结论：EIVOM可减少MI双向传导阻滞后的急性再连接，并显着增加首次通过MI传导阻滞。
