関連する実験動画

Updated: Jan 15, 2026

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

Published on: May 26, 2015

Marshall静脈を介した心房粗動のアルコール注入

Xiaohua Zhao¹, Fuding Guo¹, Sen Yang¹

¹Key Laboratory of Cardiovascular Disease of Yunnan Province, Clinical Medicine Center for Cardiovascular Disease of Yunnan Province, Department of Cardiology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China.

JACC. Case reports

|January 14, 2026

要旨

Background:

Atypical atrial flutter (AFL) after atrial fibrillation (AF) ablation, particularly when mediated by epicardial structures such as the vein of Marshall (VOM), poses a therapeutic challenge.

Case Summary:

A 64-year-old woman presented with recurrent AFL after AF ablation. High-density and entrainment mapping confirmed a macro-re-entrant circuit involving the VOM via epicardial conduction. After failed endocardial ablation, ethanol infusion into the VOM immediately terminated the tachycardia. At 1-year follow-up, the patient maintained sinus rhythm with a marked improvement in left ventricular ejection fraction (from 46% to 68%).

Discussion:

For postablation AFL, comprehensive mapping is crucial to identify epicardial substrates. VOM-mediated flutter can be effectively treated with ethanol infusion.

Take-Home Message:

This case underscores that VOM-mediated epicardial connections can sustain AFL after AF ablation, and targeted ethanol infusion is a highly effective therapeutic strategy.

キーワード:

非定型心房粗動エタノール注入 Marshall静脈

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Robotic Ablation of Atrial Fibrillation

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Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

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