{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:32:43Z","timestamp":1784892763148,"version":"3.55.0"},"reference-count":78,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The outcomes of persistent atrial fibrillation (AF) ablation are modest with various adjunctive strategies beyond pulmonary vein isolation (PVI) yielding largely disappointing results in randomised controlled trials. Linear ablation is a commonly employed adjunct strategy but is limited by difficulty in achieving durable bidirectional block, particularly at the mitral isthmus. Epicardial connections play a role in AF initiation and perpetuation. The ligament of Marshall has been implicated as a source of AF triggers and is known to harbour sympathetic and parasympathetic nerve fibres that contribute to AF perpetuation. Ethanol infusion into the Vein of Marshall, a remnant of the superior vena cava and key component of the ligament of Marshall, may eliminate these AF triggers and can facilitate the ease of obtaining durable mitral isthmus block. While early trials have demonstrated the potential of Vein of Marshall \u2018ethanolisation\u2019 to reduce arrhythmia recurrence after persistent AF ablation, further randomised trials are needed to fully determine the potential long-term outcome benefits afforded by this technique.<\/jats:p>","DOI":"10.3390\/jcm13082438","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T06:10:18Z","timestamp":1713766218000},"page":"2438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Vein of Marshall Ethanol Infusion for AF Ablation; A Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Louisa","family":"O\u2019Neill","sequence":"first","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium"},{"name":"Department of Cardiology, Blackrock Clinic, A94 E4X7 Dublin, Ireland"},{"name":"King\u2019s College London, St. Thomas\u2019 Hospital, London SE1 9NH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1839-3693","authenticated-orcid":false,"given":"Benjamin","family":"De Becker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"De Smet","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Francois","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene","family":"Tavernier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Duytschaever","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Benoit","family":"Le Polain De Waroux","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Knecht","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2746","DOI":"10.1093\/eurheartj\/eht280","article-title":"Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060","volume":"34","author":"Krijthe","year":"2013","journal-title":"Eur. 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