{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T04:46:37Z","timestamp":1776746797706,"version":"3.51.2"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ethanol infusion of the vein of Marshall (EIVOM) has emerged as a promising adjunct to pulmonary vein isolation (PVI) for atrial fibrillation (AF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing catheter ablation for persistent AF (&amp;gt;3 months) were enrolled in this study. After PVI, high-density mapping (HD-Grid, Abbott, St Paul, MN) was performed during coronary sinus pacing (100\u2005bpm) to assess left atrial conduction velocity (CV) and voltage. EIVOM was then performed (1\u20133\u2005mL ethanol\u2009\u00d7\u20093 doses), followed by repeat mapping. The CV and voltage were analyzed in the left lateral wall (mitral isthmus\/appendage base), with \u2265300 points collected per region. A post-EIVOM electrophysiological study with isoprenaline was conducted to induce arrhythmias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty patients with AF (mean age, 64.30 [SD, 7.97] years, five women [25.0%]) with 24 (interquartile range: 6\u201360) months of AF duration underwent EIVOM (7.8\u2009\u00b1\u20092.1\u2005mL). Voltage dropped from 1.92 (1.12\u20132.61) to 1.24 (0.91\u20132.05) mV postprocedure (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), particularly in the atrial ridge regions. CV remained unchanged (1.00 [0.92\u20131.10] vs. 1.02 [0.95\u20131.14] m\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15). Atrial flutter was induced in three patients (one mitral isthmus-dependent, one tricuspid isthmus-dependent, and one roof-dependent). All patients maintained sinus rhythm at discharge without complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the acute setting, EIVOM induces localized voltage reduction in the atrial ridge regions without markedly affecting conduction velocity in the mitral isthmus areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1807237","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T04:22:47Z","timestamp":1776745367000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ethanol infusion of the vein of Marshall reduces localized voltage but preserves mitral isthmus conduction velocity"],"prefix":"10.3389","volume":"13","author":[{"given":"Yi","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]},{"name":"State Key Laboratory of Transvascular Implantation Devices","place":["Hangzhou, China"]},{"name":"Heart Regeneration and Repair Key Laboratory of Zhejiang Province","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]},{"name":"State Key Laboratory of Transvascular Implantation Devices","place":["Hangzhou, China"]},{"name":"Heart Regeneration and Repair Key Laboratory of Zhejiang Province","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunhui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]},{"name":"State Key Laboratory of Transvascular Implantation Devices","place":["Hangzhou, China"]},{"name":"Heart Regeneration and Repair Key Laboratory of Zhejiang Province","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shenghui","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]},{"name":"State Key Laboratory of Transvascular Implantation Devices","place":["Hangzhou, China"]},{"name":"Heart Regeneration and Repair Key Laboratory of Zhejiang Province","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhejun","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]},{"name":"State Key Laboratory of Transvascular Implantation Devices","place":["Hangzhou, China"]},{"name":"Heart Regeneration and Repair Key Laboratory of Zhejiang Province","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1093\/eurheartj\/ehm606","article-title":"The architecture of the left lateral atrial wall: a particular anatomic region with implications for ablation of atrial fibrillation","volume":"29","author":"Cabrera","year":"2008","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1016\/j.hrthm.2009.07.036","article-title":"Ethanol infusion in the vein of Marshall: adjunctive effects during ablation of atrial fibrillation","volume":"6","author":"Valderrabano","year":"2009","journal-title":"Heart 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