Po-01-036 the outcomes of ablation with vein of marshall ethanol infusion vs. ablation alone in patients with untreated persistent atrial fibrillation: case-control, single-center study

Ablation with the vein of Marshall ethanol infusion (VOM-ABL) is a relatively new therapeutic option for persistent atrial fibrillation (AF) compared with pulmonary vein isolation (PVI). We aimed to explore whether VOM-ABL showed better efficacy compared with PVI alone in untreated persistent AF. The study included consecutive patients who underwent VOM-ABL for untreated persistent AF at a single center between September 2021 and August 2022 as the study group. Consecutive patients who underwent PVI alone for untreated persistent AF between October 2019 and December 2020 were retrospectively included as the control group. The primary endpoint was freedom from AF/atrial tachycardia (AT) for longer than 30 seconds after the procedure during follow-up. The study group consisted of 88 patients (56.18±10.63 years) undergoing adjunctive VOM-ABL. The control group consisted of 102 patients (57.42±11.50 years) undergoing PVI alone. The proportion of patients with recurrences of AF/AT after a single procedure was 22 (25.0%) in the VOM-ABL group compared with 18 (17.6%) in the PVI alone group (P = 0.215) (Table 1). During a median follow-up of 4 months in the VOM-ABL group, and a median follow-up of 6 months in the PVI alone group, the time to recurrence of AF/AT was not significantly different either (P = 0.052) (Figure1). In addition, the perioperative complications and readmission incidence were similar between groups (Table 1). In patients with untreated persistent AF, the rate and time of recurrences of AF/AT after a single procedure were not significantly different between patients undergoing adjunctive VOM-ABL and patients undergoing PVI alone. Therefore, the need for adjunctive VOM-ABL in patients with persistent AF treated for the first time still requires longer follow-up and more in-depth exploration.