Comparative Study of Cryoballoon versus Radiofrequency for Pulmonary Vein Isolation when Combined with vein of Marshall Ethanol Infusion for Paroxysmal Atrial Fibrillation

Okishige, Kaoru; Kawaguchi, Naohiko; Iwai, Shinsuke; Yamauchi, Yasuteru; Keida, Takehiko; Sasano, Tetsuo; Hirao, Kazuyuki; Valderrábano, Miguel

doi:10.4022/jafib.2253

Journal of Atrial Fibrillation

2020

DOI: 10.4022/jafib.2253

|View full text |Cite

Comparative Study of Cryoballoon versus Radiofrequency for Pulmonary Vein Isolation when Combined with vein of Marshall Ethanol Infusion for Paroxysmal Atrial Fibrillation

Kaoru Okishige

Naohiko Kawaguchi

Shinsuke Iwai

et al.

Abstract: Marshall (VOM-EI) has been proposed as a potentially synergistic adjunctive therapeutic strategy for AF [8,9] . The aim of this study is to investigate whether a VOM-EI translates into an improved rhythm control in paroxysmal AF, and whether the technique chosen for the PVI (RF or CB) has any influence when combined with a VOM-EI. Methods Patients PopulationPatients 44 to 82 years of age who had experienced multiple episodes of AF within the previous 6 months were consecutively enrolled in the study. Patients … Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2021

2023

Publication Types

Select...

Article3

Relationship

Self Cite0

Independent3

Authors

Journals

Cited by 3 publications

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Efficacy and feasibility of vein of Marshall ethanol infusion during persistent atrial fibrillation ablation: A systematic review and meta‐analysis

Ge,

Li,

et al. 2023

Clinical Cardiology

View full text Add to dashboard Cite

BackgroundCatheter ablation (CA) is currently used to treat persistent atrial fibrillation (PeAF). However, its effectiveness is limited. This study aimed to estimate the effectiveness of the vein of Marshall absolute ethanol injection (VOM‐EI) for PeAF ablation.HypothesisAdjunctive vein of Marshall ethanol injection (VOM‐EI) strategies are more effective than conventional catheter ablation (CA) and have similar safety outcomes.MethodsWe extensively searched the literature for studies evaluating the effectiveness and safety of VOM‐EI + CA compared with CA alone. The primary endpoint was the rate of acute bidirectional block of the isthmus of the mitral annulus (MIBB). The secondary endpoints were atrial fibrillation (AF) or atrial tachycardia (AT) recurrence over 30 seconds after a 3‐month blanking period. Weighted pooled risk ratios (RRs) and corresponding 95% confidence intervals (CIs) were calculated using a random effects model.ResultsBased on the selection criteria, nine studies were included in this systematic review, including patients with AF (n = 2508), persistent AF (n = 1829), perimitral flutter (n = 103), and perimitral AT (n = 165). There were 1028 patients in the VOM‐EI + CA group and 1605 in the CA alone group. The VOM‐EI + CA group showed a lower rate of AF/AT relapse (RR = 0.70; 95% CI = 0.53–0.91; p = .008) and a higher rate of acute MIBB (RR = 1.29; 95% CI = 1.11–1.50; p = .0007) than the CA alone group.ConclusionOur meta‐analysis revealed that adjunctive VOM‐EI strategies are more effective than conventional CA and have similar safety outcomes.

show abstract

Efficacy and feasibility of vein of Marshall ethanol infusion during persistent atrial fibrillation ablation: A systematic review and meta‐analysis

Ge,

Li,

et al. 2023

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

Feasibility, efficacy, and safety of ethanol infusion into the vein of Marshall for atrial fibrillation: A meta‐analysis

Ze-min

Yang

Bai

et al. 2021

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background Contemporary radiofrequency catheter ablation (RFCA) approaches for atrial fibrillation (AF) have reached an efficacy “ceiling”. Ethanol infusion into the vein of Marshall (EI‐VOM) has shown potential in preliminary studies. Data on EI‐VOM are largely limited to small single‐center reports, and clinical benefits and risks have not been systematically examined. Therefore, we performed a meta‐analysis to assess the feasibility, efficacy, and safety of EI‐VOM for AF. Methods All studies evaluating EI‐VOM for AF were initially searched from four electronic search engines: PubMed, Web of Science, Cochrane Library, and SinoMed. We used RevMan5.4 to calculate pooled outcomes of randomized controlled trial and cohort studies. We also performed single‐arm meta‐analyses using Open Meta‐Analyst. Results We included a total of 10 studies with 1322 patients. Successful EI‐VOM was performed in 86.7% (95% CI 81.9–91.4%) of patients. For persistent AF patients, the recurrence of AF and/or atrial tachycardia (AT) was significantly lower in the EI‐VOM combined with RFCA group compared with RFCA alone group (RR 0.58, 95% CI 0.35 to 0.96, p = 0.04). EI‐VOM combined with RFCA significantly increased the rate of bidirectional mitral isthmus block compared with RFCA alone in AF patients (RR 1.50, 95% CI 1.34 to 1.67, p < 0.001). There were nine cardiac tamponades observed in 644 patients (PR 0.8%, 95% CI 0.1–1.5%) who were performed EI‐VOM combined with RFCA. Conclusions Our meta‐analysis brings encouraging evidence that adjuvant EI‐VOM reduces AF and/or AT recurrence rate in persistent AF patients and increases the success rate of bidirectional mitral isthmus block.

show abstract

The Long-Term Outcomes of Ablation With Vein of Marshall Ethanol Infusion vs. Ablation Alone in Patients With Atrial Fibrillation: A Meta-Analysis

Sun

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundThe long-term outcomes of ablation with vein of Marshall ethanol infusion (VOM-ABL) compared with ablation alone in patients with atrial fibrillation (AF) remains elusive. We aimed to explore whether VOM-ABL showed better long-term benefits and screen the potential determinants of outcome impact of VOM-ABL procedure.MethodsPubMed, Cochrane Library, Web of Science, and Embase were searched up to 1st September 2021. Studies comparing the long-term (one-year or longer) outcomes between VOM-ABL and ablation alone were included. Subgroup analysis identified potential determinants for VOM-ABL procedure.ResultsCompared with ablation alone, VOM-ABL was associated with a significantly higher rate of long-term freedom from AF/AT (risk ratio [RR], 1.28; 95% confidence interval [CI], 1.12–1.47; p = 0.00) and successful mitral isthmus (MI) block (RR, 1.52; 95% CI, 1.16–1.99; p = 0.00), whereas, there was no significant difference in pericardial effusion, stroke/transient ischemic attack (TIA), and all-cause death. Subgroup analysis identified two significant treatment-covariate interactions: one was ablation strategy subgroup (pulmonary vein isolation plus linear and/or substrate ablation [PVI+]; RR, 1.41; 95% CI, 1.27–1.56 vs. PVI; RR, 1.05; 95% CI, 0.92–1.19, p = 0.00 for interaction) for freedom from AF/AT, while the other was VOM-ABL group sample size subgroup (≥ 100; RR, 1.98; 95% CI, 1.24–3.17 vs. <100; RR, 1.20; 95% CI, 1.10–1.30, p = 0.04 for interaction) for MI block.ConclusionsThis meta-analysis demonstrates that VOM-ABL has superior efficacy and comparable safety over ablation alone in AF patients with long-term follow-up. Moreover, PVI+ and VOM-ABL group sample size ≥ 100 may be associated with a great impact on freedom from AF/AT and MI block, respectively.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Comparative Study of Cryoballoon versus Radiofrequency for Pulmonary Vein Isolation when Combined with vein of Marshall Ethanol Infusion for Paroxysmal Atrial Fibrillation

Cited by 3 publications

References 36 publications

Efficacy and feasibility of vein of Marshall ethanol infusion during persistent atrial fibrillation ablation: A systematic review and meta‐analysis

Efficacy and feasibility of vein of Marshall ethanol infusion during persistent atrial fibrillation ablation: A systematic review and meta‐analysis

Feasibility, efficacy, and safety of ethanol infusion into the vein of Marshall for atrial fibrillation: A meta‐analysis

The Long-Term Outcomes of Ablation With Vein of Marshall Ethanol Infusion vs. Ablation Alone in Patients With Atrial Fibrillation: A Meta-Analysis

Contact Info

Product

Resources

About