Arrhythmias & electrophysiologyMeta-analysis
Ethanol infusion of the vein of marshall-based strategies for persistent atrial fibrillation: a systematic review and meta-analysis of randomized trials
- Systematic review and meta-analysis of randomised trials
- random-effects
- trial sequential analysis
Authors' conclusion
In PeAF, EIVOM-based ablation strategies significantly improve 12-month arrhythmia-free survival and reduce repeat procedures without increasing major adverse events.
Study context
- Population
- Persistent AF
- Participants
- 1,179 participants · 5 randomized controlled trials (RCTs)
- Comparison
- Ethanol infusion of the vein of Marshall (EIVOM)-based ablation strategies vs control
- EIVOMn = 602
- controln = 577reference
- Outcome
- Freedom from any atrial arrhythmia
- Follow-up
- 12 months
Pooled result
Freedom from any arrhythmia
Relative risk
1.16
95% CI 1.04–1.29
P < 0.001
EIVOM vs control
RR 1.16 (95% CI 1.04–1.29); P < 0.001
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Freedom from AF · NNT = 13 | 1.11 (1.05–1.18) | P < 0.001 | |
| 0.512Relative risk (log scale) |
Recurrence hazard (time-to-event analysis)
- Sustained reduction in recurrence hazard, HR
- 0.72 (95% CI 0.64-0.81; P = 0.003; I2 = 0%)
Repeat ablation
- Repeat ablation reduced, RR (P = 0.009)
- 0.61
Safety
Major complications
- Major complications comparable (P = 0.47)
- 2.5% vs. 2.8%
Fluoroscopy time
- Fluoroscopy time increased (P = 0.007)
- +9.08 min
Original publication
Ethanol infusion of the vein of marshall-based strategies for persistent atrial fibrillation: a systematic review and meta-analysis of randomized trials. Europace. Published 2 April 2026. doi:10.1093/europace/euag069
Summarised from the published abstract; every number is checked against it