Trial reportHeart rhythm2021
Determinants of outcome impact of vein of Marshall ethanol infusion when added to catheter ablation of persistent atrial fibrillation: A secondary analysis of the VENUS randomized clinical trial.
Trial report in Heart rhythm, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Ethanol Infusion in the Vein of Marshall for Persistent Atrial Fibrillation Ablation: Evidence From Randomized Controlled Trials.Journal of cardiovascular electrophysiology · 2025Pooled it
- Continuous positive airway pressure therapy might be an effective strategy on reduction of atrial fibrillation recurrence after ablation in patients with obstructive sleep apnea: insights from the pooled studies.Frontiers in neurology · 2023Pooled it
- Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies.Frontiers in physiology · 2023Pooled it
- Marshall-Plan Ablation Strategy Versus Pulmonary Vein Isolation in Persistent AF: A Randomized Controlled Trial.Circulation. Arrhythmia and electrophysiology · 2025Trial
- Ethanol Infusion Into the Vein of Marshall for Atrial Fibrillation: Clinical Efficacy and Technical Limitations.Clinical cardiology · 2026Review
- The Role of Ethanol Ablation of the Vein of Marshall in the Era of Pulsed Field Ablation.Journal of clinical medicine · 2026Review
- Ethanol infusion of the vein of Marshall reduces localized voltage but preserves mitral isthmus conduction velocity.Frontiers in cardiovascular medicine · 2026Article
- Management of patients with atrial tachycardia: a clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), and the Association for European Paediatric and Congenital Cardiology (AEPC).Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Tips and Tricks to Perform a Successful Vein of Marshall Alcohol Ablation.The Journal of innovations in cardiac rhythm management · 2025Review
- Beyond the pulmonary vein isolation-is alcohol substrate modification the best option for persistent atrial fibrillation?Journal of thoracic disease · 2025Article
- Vein of Marshall ethanol infusion improves ablation outcomes in patients with persistent atrial fibrillation.Heart rhythm O2 · 2025Article
- Catheter Ablation of Atrial Fibrillation: Technique and Future Perspectives.Journal of clinical medicine · 2025Review
- Clinical neurocardiology: defining the value of neuroscience-based cardiovascular therapeutics - 2024 update.The Journal of physiology · 2025Review
- Integrated Management of Persistent Atrial Fibrillation.Biomedicines · 2025Review
- Chronic Effects of Vein of Marshall Ethanol Infusion on Pulmonary Vein and Mitral Isthmus Reconnection.Arrhythmia & electrophysiology review · 2025Article
- 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.Journal of arrhythmia · 2024Article
- Protocol modifications reduce risk of delayed pericardial effusions after vein of Marshall ethanol infusion: follow-up from the Maine experience.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- Anatomical Treatment Strategies for Persistent Atrial Fibrillation with Ethanol Infusion within the Vein of Marshall-Current Challenges and Future Directions.Journal of clinical medicine · 2024Review
- Combined ethanol and radiofrequency ablation for the elimination of focal atrial tachycardia originating from the Marshall bundle.Annals of medicine and surgery (2012) · 2024Article
- 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
Corrections and comments
- Commented on by
Authors and funding
19 authors at 9 institutions in 2 countries.
Funding
Abstract
backgroundThe Vein of Marshall Ethanol for Untreated Persistent AF (VENUS) trial demonstrated that adding vein of Marshall (VOM) ethanol infusion to catheter ablation (CA) improves ablation outcomes in persistent atrial fibrillation (AF). There was significant heterogeneity in the impact of VOM ethanol infusion on rhythm control.
objectiveThe purpose of this study was to assess the association between outcomes and (1) achievement of bidirectional perimitral conduction block and (2) procedural volume.
methodsThe VENUS trial randomized patients with persistent AF (N = 343) to CA combined with VOM ethanol or CA alone. The primary outcome (freedom from AF or atrial tachycardia [AT] lasting longer than 30 seconds after a single procedure) was analyzed by 2 categories: (1) successful vs no perimitral block and (2) high- (>20 patients enrolled) vs low-volume centers.
resultsIn patients with perimitral block, the primary outcome was reached 54.3% after VOM-CA and 37% after CA alone (P = .01). Among patients without perimitral block, freedom from AF/AT was 34.0% after VOM-CA and 37.0% after CA (P = .583). In high-volume centers, the primary outcome was reached in 56.4% after VOM-CA and 40.2% after CA (P = .01). In low-volume centers, freedom from AF/AT was 30.77% after VOM-CA and 32.61% after CA (P = .84). In patients with successful perimitral block from high-volume centers, the primary outcome was reached in 59% after VOM-CA and 39.1% after CA (P = .01). Tests for interaction were significant (P = .002 for perimitral block and P = .04 for center volume).
conclusionAdding VOM ethanol infusion to CA has a greater impact on outcomes when associated with perimitral block and performed in high-volume centers. Perimitral block should be part of the VOM procedure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.