Intramural Venous Ethanol Infusion for Refractory Ventricular Arrhythmias

Tavares, Liliana; Lador, Adi; Fuentes, Stephanie; Da-Wariboko, Akanibo; Błaszyk, Krzysztof; Małaczyńska-Rajpold, Katarzyna; Papiashvili, Giorgi; Korolev, S. V.; Peichl, Petr; Kautzner, Josef; Webber, Matthew; Hooks, Darren; Rodríguez‐Mañero, Moisés; Toro, Darío Di; Labadet, Carlos; Sasaki, Takeshi; Okishige, Kaoru; Patel, Apoor; Schürmann, Paul; Dave, Amish S.; Rami, Tapan G.; Valderrábano, Miguel

doi:10.1016/j.jacep.2020.07.023

Cited by 55 publications

(55 citation statements)

References 18 publications

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“…Exact mechanisms underlying the acute suppression of PVCs during occlusive venogram remains unknown but is likely multifactorial. While unintended, our findings if present, may be helpful in localizing the arrhythmogenic focus of LV summit VA, and adds to the feasibility of retrograde ethanol ablation for LV summit VA which has been recently described 6 …”

Section: Discussionmentioning

confidence: 65%

Acute suppression of epicardial left ventricular summit premature ventricular ectopy by occlusive venogram

Tan

Seow

2021

Pacing Clinical Electrophis

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We describe the unique phenomenon of occlusive venogram‐induced suppression of premature ventricular complexes (PVC) arising from the epicardial left ventricular summit (LVS). Prior to ablation through the coronary sinus, routine occlusive venogram performed at the focus of PVC origin led to localized myocardial staining and simultaneous, sustained PVC suppression. Pace‐mapping adjacent to the area of myocardial staining revealed near‐identical PVC morphology match (98%). Routine occlusive venogram prior to ablation within the coronary venous system is safe and contributed to localization of the PVC focus.

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Section: Discussionmentioning

confidence: 65%

Acute suppression of epicardial left ventricular summit premature ventricular ectopy by occlusive venogram

Tan

Seow

2021

Pacing Clinical Electrophis

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“…Catheter ablation failure poses a clinical challenge for patients with epicardial or intramural VA. The efficacy of retrograde coronary venous ethanol infusion to treat prior failed ventricular tachycardia (VT) has been reported, 4 but there are potential risk of off-target myocardial injury attributable to ethanol leak. Bipolar ablation is also an alternative for deeply originated arrhythmia: when targeting the LV summit, bipolar energy was delivered between the GCV / anterior interventricular vein and opposite endocardium; however, this approach requires optimal anatomic conditions.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Other bailout approaches, including half normal saline ablation and needle ablation, have also been reported, 6 but the relative merits of these are yet to be established. 2 , 4 , 7 …”

Section: Discussionmentioning

confidence: 99%

Guidewire ablation of epicardial ventricular arrhythmia within the coronary venous system: A case report

Xuan

Liang

et al. 2022

HeartRhythm Case Reports

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“…For such cases, various bail-out strategies were proposed. These include transcoronary arterial or venous alcohol ablation, 76,77 bipolar ablation, 78 use of high-impedance irrigant, 79 radiofrequency needle ablation, 80 and surgical ablation. 81 At this time, all of these techniques are used on an individual basis and can be considered investigational.…”

Section: Outcome Of Catheter Ablationmentioning

confidence: 99%

Management of ventricular arrhythmias in heart failure: Current perspectives

2021

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Congestive heart failure (HF) is a progressive affliction defined as the inability of the heart to sufficiently maintain blood flow. Ventricular arrhythmias (VAs) are common in patients with HF, and conversely, advanced HF promotes the risk of VAs. Management of VA in HF requires a systematic, multimodality approach that comprises optimization of medical therapy and use of implantable cardioverter-defibrillator and/or device combined with cardiac resynchronization therapy. Catheter ablation is one of the most important strategies with the potential to abolish or decrease the number of recurrences of VA in this population. It can be a curative strategy in arrhythmia-induced cardiomyopathy and may even save lives in cases of an electrical storm. Additionally, modulation of the autonomic nervous system and stereotactic radiotherapy have been introduced as novel methods to control refractory VAs. In patients with end-stage HF and refractory VAs, an institution of the mechanical circulatory support device and cardiac transplant may be considered. This review aims to provide an overview of current evidence regarding management strategies of VAs in HF with an emphasis on interventional treatment.

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Intramural Venous Ethanol Infusion for Refractory Ventricular Arrhythmias

Cited by 55 publications

References 18 publications

Acute suppression of epicardial left ventricular summit premature ventricular ectopy by occlusive venogram

Acute suppression of epicardial left ventricular summit premature ventricular ectopy by occlusive venogram

Guidewire ablation of epicardial ventricular arrhythmia within the coronary venous system: A case report

Management of ventricular arrhythmias in heart failure: Current perspectives

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