Retrograde Coronary Venous Infusion of Ethanol for Ablation of Canine Ventricular Myocardium

Kn, Wright; T, Morley; Bicknell, Jeanette L.; Sp, Bishop; Gp, Walcott; Gn, Kay

doi:10.1111/j.1540-8167.1998.tb00138.x

Cited by 28 publications

(18 citation statements)

References 18 publications

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“…Wright et al [40] explored the retrograde venous approach in a canine model. Balloon occlusion of the distal anterior inter-ventricular vein or the distal great cardiac vein was performed and then ethanol was infused at 1.5, 3, and 5 ml.…”

Section: Using the Venous Route For Ethanol Deliverymentioning

confidence: 99%

Ethanol for the treatment of cardiac arrhythmias

Schürmann

Peñalver

Valderrábano

2015

Current Opinion in Cardiology

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Introduction Ethanol infusion was an early mode of ablative treatment for cardiac arrhythmias. Its initial descriptions involved coronary intra-arterial delivery, targeting arrhythmogenic substrates in drug-refractory ventricular tachycardia or the atrioventricular node. Largely superseded by radiofrequency ablation (RFA) and other contact-based technologies as a routine ablation strategy, intracoronary arterial ethanol infusion remains as an alternative option in the treatment of ventricular tachycardia when conventional ablation fails. Arrhythmic foci that are deep-seated in the myocardium may not be amenable to catheter ablation from either the endocardium or the epicardium by RFA, but they can be targeted by an ethanol infusion. Recent findings Recently, we have explored ethanol injection through cardiac venous systems, in order to avoid the risks of complications and limitations of coronary arterial instrumentation. Vein of Marshall ethanol infusion is being studied as an adjunctive procedure in ablation of atrial fibrillation, and coronary venous ethanol infusion for ventricular tachycardia. Conclusion Ethanol ablation remains useful as a bail-out technique for refractory cases to RFA, or as an adjunctive therapy that may improve the efficacy of catheter ablation procedures.

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Section: Using the Venous Route For Ethanol Deliverymentioning

confidence: 99%

Ethanol for the treatment of cardiac arrhythmias

Schürmann

Peñalver

Valderrábano

2015

Current Opinion in Cardiology

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“…RCVEA has also been shown to successfully terminate VTs in dogs (7), however, it has never been tested in human subjects. To develop this technique, we built on our extensive experience in safely using ethanol infusion of the vein of Marshall during the treatment of atrial fibrillation (8-10).…”

Section: Discussionmentioning

confidence: 99%

“…Catheter instrumentation in the coronary veins lacks the risks of arterial damage, and retrograde flow drives spilled ethanol towards the right atrium where it is diluted to non-damaging concentrations. This approach was first described by Wright et al in dogs (7) but, to our knowledge, has not yet been tested on human subjects. Here, we describe two cases in which RCVEA successfully terminated persistent VTs refractory to multiple RFCA procedures.…”

Section: Introductionmentioning

confidence: 99%

Coronary venous ethanol infusion for the treatment of refractory ventricular tachycardia

2012

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“…17 The resultant necrosis was focal Injection of 100% ethanol into the canine coronary venous circulation caused myocardial necrosis. 18 Transventricular injection of 60% ethanol in dogs produced coagulative necrosis and haemorrhage, with a narrow border zone consisting of myocytes with neutrophilic infiltration. 19 After 1 month, there was dense fibrosis with mild to moderate inflammation.…”

Section: Effects Of Ethanol Injectionmentioning

confidence: 99%

Pathological effects of alcohol septal ablation for hypertrophic obstructive cardiomyopathy

Baggish

Smith

Palacios

et al. 2006

Heart

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Background: The pathological effects and the mechanisms of action of intracoronary administration of ethanol for alcohol septal ablation (ASA) for the management of hypertrophic obstructive cardiomyopathy (HOCM) are unknown. Methods: We examined surgical specimens and, in one case, autopsy specimens from four patients who underwent surgical septal myectomy 2 days to 14 months after unsuccessful ASA. Results: Pathological examination early after ASA showed coagulative necrosis of both the myocardium and the septal perforator arteries. Affected arteries were distended and occluded by necrotic intraluminal debris, without platelet-fibrin thrombi. Late after unsuccessful ASA, excised septal tissue was heterogeneous, containing a region of dense scar, and adjacent tissue containing viable myocytes and interspersed scar. Conclusions: Intracoronary administration of ethanol in patients with HOCM causes acute myocardial infarction with vascular necrosis. The coagulative necrosis of the arteries, their distension by necrotic debris and the absence of platelet-fibrin thrombi distinguish ethanol-induced infarction from that caused by atherosclerotic coronary artery disease. The direct vascular toxicity of ethanol may be an important aspect of the mechanism of successful ASA.

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Retrograde Coronary Venous Infusion of Ethanol for Ablation of Canine Ventricular Myocardium

Cited by 28 publications

References 18 publications

Ethanol for the treatment of cardiac arrhythmias

Ethanol for the treatment of cardiac arrhythmias

Coronary venous ethanol infusion for the treatment of refractory ventricular tachycardia

Pathological effects of alcohol septal ablation for hypertrophic obstructive cardiomyopathy

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