{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T19:27:43Z","timestamp":1786390063532,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Durable mitral isthmus (MI) block remains challenging in persistent atrial fibrillation (AF) ablation. Ethanol infusion into the vein of Marshall (EI\u2010VOM) enhances efficacy, but the minimal endocardial ablation extent post\u2010EI\u2010VOM is undefined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study (June 2024\u2013March 2025) enrolled 35 persistent AF patients undergoing first\u2010time ablation: EI\u2010VOM (11.10\u00a0\u00b1\u00a02.24\u00a0mL ethanol), bilateral pulmonary vein isolation (PVI), linear ablations, and stepwise MI ablation. Endpoints included acute MI block, lesion requirements, and 6\u2010month sinus rhythm (SR) maintenance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Left PVI demonstrated significantly shorter ablation time versus right\u2010sided PVI (10.94\u00a0\u00b1\u00a05.31\u00a0min vs. 18.77\u00a0\u00b1\u00a07.27\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01), while acute MI block was achieved in 88.6% (31\/35) of patients with 5.03\u00a0\u00b1\u00a04.51 endocardial lesions\u2014notably fewer in smaller left atria (diameter &lt;45 mm: 4.1\u00a0\u00b1\u00a03.9\u00a0vs. \u226545 mm: 6.8\u00a0\u00b1\u00a05.1 lesions,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03). EI\u2010VOM enabled 90% of MI blocks with partial endocardial ablation. SR maintenance reached 91.4% (3\u2010month) and 88.5% (6\u2010month), showing no correlation with MI block or clinical variables (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.05), with zero major complications recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EI\u2010VOM synergizes with partial endocardial ablation for MI block, particularly in non\u2010dilated left atria (&lt;45\u00a0mm). Adjunctive coronary sinus ablation is essential for dilated atria. High mid\u2010term SR stability (88.5%) supports strategy efficacy, though non\u2010anatomical factors influence recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70116","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:33:25Z","timestamp":1773758005000},"page":"1159-1167","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modified Anatomical Ablation Strategy for Mitral Isthmus"],"prefix":"10.1111","volume":"49","author":[{"given":"Kui","family":"He","sequence":"first","affiliation":[{"name":"Wenzhou Medical University  Zhejiang China"},{"name":"Department of Cardiology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6497-9962","authenticated-orcid":false,"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengqi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangbo","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Cardiology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3762-7977","authenticated-orcid":false,"given":"Weili","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Cardiology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yafei","family":"Mi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University  Zhejiang 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