{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:15:57Z","timestamp":1782782157790,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":76,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Cardiovascular Therapeutics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The vein of Marshall (VOM) ethanol infusion is an adjunctive strategy for persistent atrial fibrillation (AF) ablation, traditionally guided by VOM venography. However, venography does not allow real\u2010time evaluation of ethanol distribution and carries procedural risks. Intracardiac echocardiography (ICE) provides high\u2010resolution visualization for precise guidance but remains understudied clinically. This study was aimed at evaluating the feasibility, efficacy, and safety of a novel ICE\u2010guided VOM ethanol infusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, matched cohort study was conducted including 126 patients (42 ICE\u2010guided, 84 venography\u2010guided) undergoing de novo radiofrequency (RF) catheter ablation for persistent AF. Propensity score matching (1:2) balanced the groups\u2032 baseline characteristics. Procedural endpoints included ethanol\u2010induced low\u2010voltage area (LVA), procedural efficiency (procedure duration and radiation exposure), complications, and 12\u2010month AF\/atrial tachycardia (AT) recurrence. ICE\u2010guided procedures utilized real\u2010time monitoring of ethanol\u2010induced tissue changes, whereas venography relied on contrast extravasation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ICE guidance produced significantly larger ethanol\u2010induced LVAs, shorter total procedure times, reduced fluoroscopy times, shorter VOM ethanol infusion times, shorter mitral isthmus (MI) ablation times, and lower radiation exposure (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Major complications were rare and similar between groups (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.719). At 12 months, freedom from AF\/AT recurrence was comparable between groups (log\u2010rank test,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.66).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ICE\u2010guided VOM ethanol infusion enhances procedural precision, reduces radiation exposure, and achieves more extensive substrate modification compared with venography. Although clinical recurrence rates were similar, ICE improves workflow efficiency and improves safety by avoiding distal VOM cannulation. These findings support ICE as a transformative tool for optimizing VOM ethanol ablation. Limitations include the nonrandomized design and small sample size, which warrant further validation in randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cdr\/9390824","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T02:40:10Z","timestamp":1773888010000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Novel Intracardiac Echocardiography\u2013Guided Approach for Vein of Marshall Ethanol Infusion in Persistent Atrial Fibrillation 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