{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:15:58Z","timestamp":1782782158720,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ethanol infusion into the vein of Marshall (EI\u2010VOM) is an adjunctive therapy to pulmonary vein isolation (PVI), which improves the efficacy of persistent atrial fibrillation (AF) ablation procedures. It is unknown how EI\u2010VOM scar formation impacts left atrium (LA) structure and function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize scar formation after EI\u2010VOM, and its impact on LA function, by cardiac magnetic resonance (CMR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients referred for persistent AF ablation, or any repeat procedure, were included. Ablation strategy included PVI, EI\u2010VOM and linear lesions when deemed necessary. LA was assessed by late gadolinium enhancement (LGE) CMR at baseline and 3\u2010month follow\u2010up. CMR was post\u2010processed off\u2010line with dedicated software. The LA was regionalized into 17 segments, and global and regional scarring were calculated. Strain parameters were analyzed\u2014including LA reservoir, conduit, and booster strain; LA ejection fraction; and LA passive and active emptying function. Follow\u2010up LGE\u2010CMR reconstruction was coregistered with the voltage map, ablation RF points, and fluoroscopy to compare the scar location with the VOM trajectory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 21 patients (65\u2009\u00b1\u20098 years; 76% men; 57% ablation of persistent AF). After EI\u2010VOM, 95% of patients presented new low\u2010voltage areas, all of whom exhibited new LGE\u2010CMR scarring at follow\u2010up. Voltage map and LGE\u2010CMR coregistration showed comparable scar areas (<jats:italic>p<\/jats:italic>\u2009=\u20090.287). LGE\u2010CMR scarring frequently involved the whole VOM trajectory, predominantly affecting the LA ridge, mitral isthmus, and left posterior wall. LA volume was significantly reduced after ablation, without significant changes in LA functional parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>EI\u2010VOM causes permanent scarring at 3\u2010month follow\u2010up, with no adverse impact on CMR LA functional parameters.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16491","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T11:49:24Z","timestamp":1731066564000},"page":"157-167","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Left Atrial Structure and Function Following Ethanol Infusion into Vein of Marshall (MR\u2010SHALL Study)"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4059-6297","authenticated-orcid":false,"given":"Julia","family":"Arany\u00f3","sequence":"first","affiliation":[{"name":"Heart Institute (iCOR) Germans Trias i Pujol University Hospital 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