SynthesisJournal of cardiovascular electrophysiology2025
Ethanol Infusion in the Vein of Marshall for Persistent Atrial Fibrillation Ablation: Evidence From Randomized Controlled Trials.
Synthesis in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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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
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ethanol infusion of the vein of marshall-based strategies for persistent atrial fibrillation: a systematic review and meta-analysis of randomized trials.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 · 2026Pooled it
- Ethanol Infusion in the Vein of Marshall as an Adjunct to Catheter Ablation in Persistent Atrial Fibrillation.Pacing and clinical electrophysiology : PACE · 2026Article
- Impact of radiofrequency power settings on acute mitral isthmus ablation success with concomitant vein of Marshall ethanol infusion.Heart rhythm O2 · 2026Article
- Acute Pericardial Effusion After Vein of Marshall Ethanol Infusion for Persistent Atrial Fibrillation.Journal of arrhythmia · 2026Article
- Management of unruptured intracranial aneurysms in atrial fibrillation: Role of ablation in anticoagulation cessation.Journal of cardiology cases · 2026Article
- The Role of Ethanol Ablation of the Vein of Marshall in the Era of Pulsed Field Ablation.Journal of clinical medicine · 2026Review
- From Shots to Shocks: When Ethanol Isn't RF's Friend-Pericardial-Esophageal Fistula After Combined Ethanol and Radiofrequency Ablation.JACC. Case reports · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundPulmonary vein isolation (PVI) is the cornerstone of catheter ablation (CA) for atrial fibrillation (AF), yet outcomes remain suboptimal in persistent AF patients. Ethanol infusion in the vein of Marshal (VoM), an embryological remnant implicated in AF pathogenesis, may enhance ablation efficacy.
objectiveTo evaluate the effectiveness of VoM ethanol infusion in patients with persistent AF.
methodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCT) comparing CA with versus without VoM ethanol infusion in patients undergoing first-time ablation of persistent AF. The primary endpoint was freedom from any atrial arrhythmia in a 12-month follow-up.
resultsFour RCTs including 1045 patients were analyzed (VoM + CA-535 patients vs. CA alone-510 patients). Ethanol infusion in the VoM significantly increased freedom from atrial arrhythmias (RR 1.21; 95% CI 1.010-1.32; p < 0.0001, NNT 10) and reduced the need of a repeat procedure (RR 0.63; 95% CI 0.45-0.87; p = 0.005). Mitral isthmus (MI) block was more frequently achieved in the VoM group (RR 1.30; 95% CI 1.03-1.65; p = 0.03) There was no significant difference in the rate of major complications (2.8% vs. 3.5%, RR 0.72; 95% CI 0.37-1.43; p = 0.35, NNH 138), although overall complications were more frequent in the VoM ethanol infusion group (RR 2.25; 95% CI 1.08-4.70; p = 0.03).
conclusionWhen added to CA, ethanol infusion in the VoM improves freedom from arrhythmia without increasing the risk of major complications. These findings may support its integration into ablation strategies for persistent AF.
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