Skip to main content
Erschienen in: Current Cardiology Reports 9/2023

14.07.2023 | Invasive Electrophysiology and Pacing (EK Heist, Section Editor)

Venous Ethanol Ablation Approaches for Radiofrequency-Refractory Cardiac Arrhythmias

verfasst von: Stephanie Fuentes, Miguel Valderrábano

Erschienen in: Current Cardiology Reports | Ausgabe 9/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

In this review, we summarize the procedural approach and outcomes of venous ethanol infusion in the treatment of ventricular arrhythmias with intramural site of origin.

Recent Findings

Coronary venous ethanol infusion has emerged as a novel, safe, and effective adjunctive strategy to radiofrequency ablation of drug refractory ventricular arrhythmias with an intramural origin.

Summary

Radiofrequency catheter ablation is the first-line treatment for drug refractory ventricular arrythmias. Its success is highly dependent on the ability to reach targeted myocardium. Radiofrequency failures are common in patients with ventricular arrhythmias arising from deep intramural substrates, and those whose origin is in close proximity to vital structures such as coronary arteries or the phrenic nerve. Coronary venous ethanol infusion has emerged as a novel technique that circumvents these limitations.
Literatur
10.
Zurück zum Zitat Brugada P, de Swart H, Smeets L, Wellens HJ. Clinical investigation transcoronary chemical ablation of ventricular tachycardia address for correspondence and reprints. http://ahajournals.org. Brugada P, de Swart H, Smeets L, Wellens HJ. Clinical investigation transcoronary chemical ablation of ventricular tachycardia address for correspondence and reprints. http://​ahajournals.​org.
11.
Zurück zum Zitat Neal Kay G, Epstein AE, Bubien RS, et al. Intracoronary ethanol ablation for the treatment of recurrent sustained ventricular tachycardia. 19. Neal Kay G, Epstein AE, Bubien RS, et al. Intracoronary ethanol ablation for the treatment of recurrent sustained ventricular tachycardia. 19.
12.
Zurück zum Zitat Verna E, Repetto S, Saveri C, Forgione N, Merchant S, Binaghi G. Myocardial dissection following successful chemical ablation of ventricular tachycardia. 13:1992. Verna E, Repetto S, Saveri C, Forgione N, Merchant S, Binaghi G. Myocardial dissection following successful chemical ablation of ventricular tachycardia. 13:1992.
16.
Zurück zum Zitat Wright KN, Morley Bsbme T, Bicknell J, Bishop SP, Walcott GP, Neal Kay G. Retrograde coronary venous infusion of ethanol for ablation of canine ventricular myocardium. Wright KN, Morley Bsbme T, Bicknell J, Bishop SP, Walcott GP, Neal Kay G. Retrograde coronary venous infusion of ethanol for ablation of canine ventricular myocardium.
22.
26.
Zurück zum Zitat • Patel A, Nsahlai M, Flautt T, et al. Advanced techniques for ethanol ablation of left ventricular summit region arrhythmias. Circ Arrhythm Electrophysiol. 2022;15(8):519–29. https://doi.org/10.1161/CIRCEP.122.011017. This study delineates techniques to navigate through challenging venous anatomy when targeting LV summit ventricular arrhythmias.CrossRef • Patel A, Nsahlai M, Flautt T, et al. Advanced techniques for ethanol ablation of left ventricular summit region arrhythmias. Circ Arrhythm Electrophysiol. 2022;15(8):519–29. https://​doi.​org/​10.​1161/​CIRCEP.​122.​011017. This study delineates techniques to navigate through challenging venous anatomy when targeting LV summit ventricular arrhythmias.CrossRef
29.
Zurück zum Zitat • Fuentes Rojas SC, Malahjfi M, Tavares L, et al. Acute and long-term scar characterization of venous ethanol ablation in the left ventricular summit. JACC Clin Electrophysiol. Published online October 2022. https://doi.org/10.1016/j.jacep.2022.08.035. Finds of this study support the safety of venous ethanol ablation with regards to extent of lesion created by ethanol acutely and in long term follow up. • Fuentes Rojas SC, Malahjfi M, Tavares L, et al. Acute and long-term scar characterization of venous ethanol ablation in the left ventricular summit. JACC Clin Electrophysiol. Published online October 2022. https://​doi.​org/​10.​1016/​j.​jacep.​2022.​08.​035. Finds of this study support the safety of venous ethanol ablation with regards to extent of lesion created by ethanol acutely and in long term follow up.
33.
Zurück zum Zitat Izquierdo M, Sánchez-Gómez JM, Ferrero de Loma-Osorio A, et al. Endo-epicardial versus only-endocardial ablation as a first line strategy for the treatment of ventricular tachycardia in patients with ischemic heart disease. Circ Arrhythm Electrophysiol. 2015;8(4):882–889. https://doi.org/10.1161/CIRCEP.115.002827. Izquierdo M, Sánchez-Gómez JM, Ferrero de Loma-Osorio A, et al. Endo-epicardial versus only-endocardial ablation as a first line strategy for the treatment of ventricular tachycardia in patients with ischemic heart disease. Circ Arrhythm Electrophysiol. 2015;8(4):882–889. https://​doi.​org/​10.​1161/​CIRCEP.​115.​002827.
37.
Zurück zum Zitat •• Valderrábano M, Fuentes Rojas SC, Lador A, et al. Substrate ablation by multivein, multiballoon coronary venous ethanol for refractory ventricular tachycardia in structural heart disease. Circulation. Published online November 29, 2022.https://doi.org/10.1161/circulationaha.122.060882. Findings of this study highlight the effectiveness of multiballoon and multivein venous ethanol ablation of complex substrate in patients with structural heart disease. •• Valderrábano M, Fuentes Rojas SC, Lador A, et al. Substrate ablation by multivein, multiballoon coronary venous ethanol for refractory ventricular tachycardia in structural heart disease. Circulation. Published online November 29, 2022.https://​doi.​org/​10.​1161/​circulationaha.​122.​060882. Findings of this study highlight the effectiveness of multiballoon and multivein venous ethanol ablation of complex substrate in patients with structural heart disease.
Metadaten
Titel
Venous Ethanol Ablation Approaches for Radiofrequency-Refractory Cardiac Arrhythmias
verfasst von
Stephanie Fuentes
Miguel Valderrábano
Publikationsdatum
14.07.2023
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 9/2023
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-023-01914-6

Weitere Artikel der Ausgabe 9/2023

Current Cardiology Reports 9/2023 Zur Ausgabe

Women and Cardiovascular Health (N Goldberg and S Lewis, Section Editors)

Addressing Cardiovascular Risk Across the Arc of a Woman’s Life: Sex-Specific Prevention and Treatment

Invasive Electrophysiology and Pacing (EK Heist, Section Editor)

COVID-19 Vaccination and Cardiac Arrhythmias: A Review

Congenital Heart Disease (RA Krasuski and G Fleming, Section Editors)

Update on Transcatheter Device Closure of Congenital Septal Defects

Women and Cardiovascular Health (N Goldberg and S Lewis, Section Editors)

Cardio-Obstetrics: A Focused Review

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.