{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:15:59Z","timestamp":1782782159764,"version":"3.54.5"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Ethanol infusion into the VOM (EIVOM) adjunctive to radiofrequency catheter ablation (RFCA) was a novel approach facilitating mitral isthmus (MIth) block for persistent atrial fibrillation (PeAF); However, there were remarkable disparities in its technical aspects. This study aimed to evaluate the impact of EIVOM technical aspects on acute MIth block.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty consecutive patients (63 males, average age 66.4 \u00b1 8.6 years) undergoing <jats:italic>de novo<\/jats:italic> PeAF ablation were assigned to different groups. The procedural parameters in \u201cEIVOM first\u201d (<jats:italic>n<\/jats:italic> = 13) or \u201cRFCA first\u201d (<jats:italic>n<\/jats:italic> = 13) as well as small dose ([SD], \u22644 ml, <jats:italic>n<\/jats:italic> = 26) or big dose ([BD], &amp;gt;4 ml, <jats:italic>n<\/jats:italic> = 54) approaches were analyzed to identify the predictors for acute MIth block.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with the \u201cEIVOM first\u201d approach, the \u201cRFCA first\u201d approach was associated with longer procedural and MIth ablation time (134 \u00b1 27 min vs. 112 \u00b1 17 min; 14.9 \u00b1 5.5 min vs. 9.3 \u00b1 5.1 min, both <jats:italic>P<\/jats:italic> &amp;lt; 0.05, respectively), but with comparable success of MIth block. The ethanol dose was 6.3 \u00b1 1.5 ml in BD group vs. 3.1 \u00b1 1.0 ml in SD group (<jats:italic>P<\/jats:italic> &amp;lt; 0.001) and was correlated significantly with the size of \u0394low voltage area (<jats:italic>r<\/jats:italic> = 0.66, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). The success of MIth block was 92.6% in BD group vs. 73.1% in SD group, <jats:italic>P<\/jats:italic> = 0.03. The ethanol dose &amp;gt;5.75 ml independently predicted successful MIth block (OR: 0.428, 95% CI: 0.219\u20130.839, <jats:italic>P<\/jats:italic> = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite the comparable effectiveness on MIth block, the \u201cEIVOM first\u201d approach was associated with shorter procedural and MIth ablation time than the \u201cRFCA first\u201d approach. The ethanol dose in EIVOM was an independent predictor for MIth block.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.1031673","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T05:08:41Z","timestamp":1664860121000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of technical aspects of vein of Marshall ethanol infusion on mitral isthmus block for persistent atrial fibrillation 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