Evidence map›Paper›PMID 38914901›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024

Protocol modifications reduce risk of delayed pericardial effusions after vein of Marshall ethanol infusion: follow-up from the Maine experience.

Jordan S Leyton-Mange, Amanda D Haskell, Kunal Tandon, Andrew C Corsello, Eric Black-Maier, Edward Y Sze, Henry W Sesselberg

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Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. International Survey on Vein of Marshall Retrograde Ethanol Infusion.Circulation. Arrhythmia and electrophysiology · 2025
    Article
  4. Evaluation of posterior mitral isthmus ablation in the absence of a vein of Marshall.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 · 2024
    Article
4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Jordan S Leyton-MangeDepartment of Cardiology, Maine Medical Center, Portland, ME, 04102, USA. jordan.leyton-mange@mainehealth.org.ORCID http://orcid.org/0000-0001-8229-3326
Amanda D HaskellDepartment of Cardiology, Maine Medical Center, Portland, ME, 04102, USA.
Kunal TandonDepartment of Cardiology, Maine Medical Center, Portland, ME, 04102, USA.
Andrew C CorselloDepartment of Cardiology, Maine Medical Center, Portland, ME, 04102, USA.
Eric Black-MaierDepartment of Cardiology, Maine Medical Center, Portland, ME, 04102, USA.
Edward Y SzeDepartment of Cardiology, Maine Medical Center, Portland, ME, 04102, USA.
Henry W SesselbergDepartment of Cardiology, Maine Medical Center, Portland, ME, 04102, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile ethanol infusion into the vein of Marshall (VOM) as an adjunct to atrial fibrillation ablation has shown promise, adoption has been limited by the technical expertise required, unclear antiarrhythmic mechanism, and complication risk. Delayed pericardial effusions have been associated with ethanol infusion into the VOM in prior studies. Very little is known about how the procedural approach itself can impact the risk of delayed effusions. We sought to understand the incidence and influence of procedural technique on complications including delayed pericardial effusions from VOM ethanol infusion at a large single medical center.

methodsA total of 275 atrial ablation cases wherein VOM ethanol infusion was attempted were identified from the time of the program's inception in 2019 at Maine Medical Center (Portland, ME) until October of 2023. Cases were classified into phase I cases (early experience) and phase II cases (later experience) based upon temporal programmatic changes in the ethanol dose and infusion rate as well as the use of routine VOM venography. Procedural details and complications were adjudicated from the medical record.

resultsThe overall VOM ethanol infusion success was 91.4%. Nine complications (3.3%) occurred in eight patients (2.9% of patients). These were more frequent in phase I (5.8%) compared to phase II (1.3%, p = 0.047). This difference was driven by a difference in delayed presentations of tamponade, which occurred in four patients in phase I (3.3%) and in no patients in phase II (0%, p = 0.037). Twelve-month estimated atrial arrhythmia freedom did not differ between groups (73.8% phase I vs 70.4% phase II, p = 0.24).

conclusionIn our single-center experience, adjustments to the procedural approach with lower ethanol infusion rate and dosage, combined with utilizing selective VOM venography, associated with a lowering of complication rates and in particular, delayed pericardial tamponade.

Indexed as

Atrial FibrillationEthanolPericardial EffusionAgedCatheter AblationFemaleFollow-Up StudiesHumansInfusions, IntravenousMaineMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesEthanolAF ablationPericardial effusionVein of MarshallVOM

Identifiers

PMID38914901

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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.