PO-02-089 EMPIRIC VEIN OF MARSHALL ETHANOL INFUSION IN PATIENTS UNDERGOING REPEAT CATHETER ABLATION WITH DURABLY ISOLATED PULMONARY VEINS

The procedural strategy for patients with recurrent atrial fibrillation (AF) despite isolated pulmonary veins is unknown. Ablative strategies beyond vein isolation (PVI) have not consistently shown benefit. Vein of Marshall (VoM) ethanol ablation has a proven benefit in persistent AF undergoing index procedure, however its role durably To evaluate the empiric VoM addition to posterior wall (PWI) during repeat procedure durable from procedure. Twenty-three (age 67.1 +/- 7.4, 74% males) who received infusion PWI (study group) were matched age, gender, EF and LA size thirty-four historic receiving alone (control group). All study group underwent endocardial on mitral isthmus complete lateral line. Additional was based program trigger stimulation. Primary outcome freedom or AT after blanking period 3 months using either qualification symptoms, routine office EKG, wearable implantable monitor device (pacemaker defibrillator). Significant baseline characteristic differences between vs control included BMI (35.07 8.98 vs. 30.85 5.65, p = 0.033) incidence (83% 55%, p=0.029). 1 year AF-free survival groups 20 (86.96%) 21 (61.76%) respectively (p=0.038). Cox proportional hazard regression analysis showed significant reduction recurrence (HR 0.26, 95% CI 0.074-0.919, p=0.037). Among catheter veins, increased likelihood remaining free at 12 months. mechanism long-term success unclear. It may be due non-pulmonary triggers originating ligament Marshall, left parasympathetic denervation, transmural block across epicardial connections.