Arrhythmias & electrophysiology

Ethanol infusion of the vein of marshall-based strategies for persistent atrial fibrillation: a systematic review and meta-analysis of randomized trials

EuropacePublished Systematic review and meta-analysis of randomised trials

Pooled result · Freedom from any arrhythmiaResult — go to the resultRelative risk 1.16 95% CI 1.04–1.29

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
Methodological detailsrandom-effects, trial sequential analysis
  • Random-effects
  • Trial sequential analysis

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

OutcomeRR (95% CI)P value
Freedom from AF · NNT = 131.11 (1.05–1.18)P < 0.001

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

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