Arrhythmias & electrophysiology
Acute and Long-Term Scar Characterization of Venous Ethanol Ablation in the Left Ventricular Summit
Authors' conclusion
VEA leads to intramural ablation that can be tracked intraprocedurally by ICE and creates regions of MVO that are chronically replaced by myocardial scar. VEA scar volume does not compromise septal integrity or ventricular function.
Study context
- Population
- Patients with LV summit ventricular arrhythmias undergoing venous ethanol ablation44 with cardiac magnetic resonance (CMR)
- Participants
- 59 patients
- Outcome
- Location, extent and evolution of ablated tissue after venous ethanol ablation (VEA) (ICE echogenicity, CMR scar)
Methodological detailsMedian ethanol delivered 4 mL (IQR: 4-7 mL)
- Median ethanol delivered 4 mL (IQR: 4-7 mL)
Main finding
As reported in the abstract
Ablated intramural volume (ICE echogenicity; CMR scar)
Intracardiac echocardiography (ICE) intramural echogenicity volume, median (IQR)
2 mL
1.7–4.3
Post-ethanol CMR intramural scar (IQR)
2.5 mL
2.1–3.5 mL
Further findings
Evolution of microvascular obstruction (MVO) to scar on follow-up CMR · median 51 (IQR: 41-170) days
- Early CMR (≤48 h) MVO
- 30 of 31 patients
- MVO evolved to scar at follow-up CMR (median 51 days, IQR 41-170)
Correlations
- ICE echogenicity and CMR scar volumes correlated with each other and with ethanol volume
Original publication
Acute and Long-Term Scar Characterization of Venous Ethanol Ablation in the Left Ventricular Summit. JACC Clin Electrophysiol. Published 26 October 2022. doi:10.
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