Arrhythmias & electrophysiologyCohort study
Adjunctive ablation at the mitral isthmus in patients with left ventricular pacing leads: A retrospective multicenter analysis of safety and feasibility
- retrospective multicenter analysis
- consecutive patients
- 2 centers
- contemporaneous controls
Authors' conclusion
VOMEI and CS RFA are feasible and safe in patients with LV leads. Complications are uncommon and preclude VOMEI without causing patient morbidity when they occur, and the risk of clinically significant lead dysfunction is low.
Study context
- Population
- Patients with cardiac resynchronization therapy (CRT) who underwent Vein of Marshall ethanol infusion (VOMEI) ± coronary sinus (CS) radiofrequency ablation (RFA), with controls without CRT
- Exposure
- Patients with CRT vs controls without CRT undergoing VOMEI ± CS RFA
Main finding
As reported in the abstract
VOMEI feasibility
P = 0.92
- Overall
- 94%
Observational data: associations, not effects.
Further findings
CS RFA feasibility
P = 0.71
Arrhythmia recurrence · within 1 year
- CS RFA feasibility — Overall
- 89%
Need for alternative fluoroscopic projections, balloon-occlusion venography, or mitral isthmus block achievement
- No difference
Safety
Complications
P = 0.54
- Complications — Overall
- 5%
- Complications: precluding successful VOMEI without causing patient morbidity
Left ventricular (LV) lead parameters and lead dysfunction (CRT patients) · 43 ± 21 months of follow-up
- Lead dysfunction (phrenic capture)
- 1 case, 2%
- No significant change in LV lead parameters
Original publication
Adjunctive ablation at the mitral isthmus in patients with left ventricular pacing leads: A retrospective multicenter analysis of safety and feasibility. Heart Rhythm. Published 6 March 2026. doi:10.1016/j.hrthm.2026.02.051
Summarised from the published abstract; every number is checked against it