Front Cardiovasc Med. 2026 May 12;13:1809308. doi: 10.3389/fcvm.2026.1809308. eCollection 2026.
ABSTRACT
BACKGROUND: Recurrent atrial arrhythmia after radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF) necessitates better strategies. Ethanol infusion of the vein of Marshall (EI-VOM) is an emerging adjunct, but long-term efficacy data combined with RFCA is limited. This study compared long-term arrhythmia-free survival between RFCA combined with EI-VOM vs. RFCA alone in persistent AF patients and analyzed outcome predictors.
METHODS: Persistent AF patients were divided into EI-VOM combined with RFCA (EI-VOM + RFCA, n = 71) and RFCA alone (RFCA, n = 41) groups. Both groups underwent bilateral pulmonary vein isolation and linear ablation. The EI-VOM + RFCA group received ethanol infusion into the vein of Marshall before standard RFCA.
RESULTS: Freedom from atrial arrhythmia recurrence rates in the EI-VOM + RFCA group were significantly higher at all time points: 87.32% at 12 months, 80.25% at 24 months, and 77.46% at 36 months post-procedure. Corresponding rates in the RFCA alone group were lower: 78.05%, 65.85%, and 58.54%. Multivariate analysis identified receiving EI-VOM therapy and a smaller left atrial diameter as independent predictors of maintaining sinus rhythm long-term.
CONCLUSION: Combining EI-VOM with standard RFCA significantly reduces atrial arrhythmia recurrence compared to RFCA alone in patients with persistent AF, demonstrating superior long-term effectiveness. EI-VOM is an independent predictor of successful sinus rhythm maintenance.
PMID:42205786 | PMC:PMC13203990 | DOI:10.3389/fcvm.2026.1809308