{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:30:17Z","timestamp":1789428617690,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000},"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":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Perimitral atrial tachycardia (PMAT) is the most frequent type of iatrogenic atrial tachycardia (AT) after atrial fibrillation (AF) ablation. Vein of Marshall ethanol infusion (EIVOM) is a promising technique in mitral isthmus (MI) ablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 165 patients with PMAT were divided into three groups according to ablation strategies, including RF only group (<jats:italic>n<\/jats:italic>\u00a0=\u00a089), RF\u2010EIVOM group (initial RF ablation with adjunctive EIVOM, <jats:italic>n<\/jats:italic>\u00a0=\u00a028), and EIVOM\u2010RF group (first\u2010step EIVOM with touch\u2010up RF ablation, <jats:italic>n<\/jats:italic>\u00a0=\u00a048). Acute and follow\u2010up procedure outcomes were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PMAT terminated in 89.9%, 89.3%, and 93.7% of patients in RF only, RF\u2010EIVOM and EIVOM\u2010RF groups, respectively (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.715), with complete MI block achieved in 80.9%, 89.3%, and 95.8% of patients (EIVOM\u2010RF vs. RF only, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.012). First\u2010step utilization of EIVOM was associated with a significant shortening of RF ablation time at MI (EIVOM\u2010RF 2.1\u00a0\u00b1\u00a01.3\u00a0min, RF only 7.9\u00a0\u00b1\u00a05.9\u00a0min, RF\u2010EIVOM 6.8\u00a0\u00b1\u00a05.8\u00a0min; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) and a decrease in the proportion of patients need ablation within coronary sinus (CS, EIVOM\u2010RF 14.6%, RF only 61.8%, RF\u2010EIVOM 64.3%; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). After a mean follow\u2010up of 12.1\u00a0\u00b1\u00a06.2 months, AF\/AT recurred in 39 (43.8%), 6 (21.4%), and 12 (25.0%) patients in RF only, RF\u2010EIVOM, and EIVOM\u2010RF group (RF\u2010EIVOM vs. RF only, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.026; EIVOM\u2010RF vs. RF only, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EIVOM was associated with an enhanced acute MI block rate as well as reduced AF\/AT recurrence. First\u2010step utilization of EIVOM promises to significantly simplify the RF ablation process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Condensed abstract<\/jats:title><jats:p>PMAT is the most common type of iatrogenic AT after AF ablation procedures. EIVOM contributed to a higher acute MI block rate and lower arrhythmia recurrence risk during follow\u2010up. First\u2010step utilization of EIVOM significantly reduced the need for radiofrequency ablation at MI and inside CS with the advantage of creating a homogenous, transmural lesion and eliminating epicardial connections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14617","type":"journal-article","created":{"date-parts":[[2022,11,19]],"date-time":"2022-11-19T14:58:40Z","timestamp":1668869920000},"page":"20-30","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Vein of Marshall ethanol infusion: First\u2010step or adjunctive choice for perimitral atrial tachycardia?"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8304-7909","authenticated-orcid":false,"given":"Ming\u2010Yang","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Cardiology Beijing Anzhen Hospital National Clinical Research Centre for Cardiovascular Diseases Capital Medical University  Beijing 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