A new analysis of five studies involving 1,045 people with persistent atrial fibrillation (AF) found that adding a vein of Marshall (VOM) ethanol infusion to standard catheter ablation improves the chances of staying in normal heart rhythm. The procedure involves injecting ethanol into a small vein near the heart to target abnormal electrical signals.
Overall, 65.8% of patients who received the ethanol infusion maintained sinus rhythm during the first year after the procedure, compared with 48.6% of those who had standard ablation alone. The benefit was consistent over time, with a 27% lower risk of AF recurrence. The ethanol infusion also helped achieve complete block of the mitral isthmus in 90% of cases, which is important for preventing arrhythmias.
However, the procedure added about 10 minutes of fluoroscopy time. Complication rates were similar between groups, suggesting the extra step is safe in the short term. The studies only followed patients for one year, so longer-term outcomes are not yet known.
This is a promising strategy for improving rhythm control in persistent AF, but more research is needed to see if the benefits last beyond the first year. Patients should discuss with their doctor whether this approach is right for them.