Arrhythmias & electrophysiology
Venous Ethanol Ablation as the Sole Treatment for Intramural Ventricular Arrhythmias
Authors' conclusion
VEA-only can be effective as the sole ablation strategy when vein mapping indicates an intramural origin.
Study context
- Population
- Patients with intramural ventricular arrhythmias, some with prior failed radiofrequency ablation (RFA) proceduresprior failed RFA procedures in 24 patients · premature ventricular contraction 36 · ventricular tachycardia (VT) 16
- Participants
- 52 patients
- Outcome
- Intramural venous signal timing pre-QRS vs best endocardial or CS signals
Main finding
As reported in the abstract
P < 0.0001
Further findings
Acute VA suppression
- Ethanol volume, median
- 8 mL (Q1-Q3: 5-15 mL)
- Acute VA suppression occurred in all patients
Ablated volume
mL
- Intracardiac echocardiography
- 2.5 (Q1-Q3: 1.6-4 mL)
- Cardiac magnetic resonance imaging
- 2.8 (Q1-Q3: 2.3-7.4 mL)
Premature ventricular contraction burden
- Reduction from 21% to 0.5%
- P < 0.0001
Need for ICD therapy
- Reduction in the need for ICD therapy
- 71% of patients
Recurrence · median follow-up of 9.5 months
- Patients with recurrence
- 6
- Recurrences requiring repeat procedures
- 3 patients
Safety
Postoperative complications
- Pericarditis
- 3 patients
- Groin hematoma
- 1
- Transient right bundle branch block
- 2
Original publication
Venous Ethanol Ablation as the Sole Treatment for Intramural Ventricular Arrhythmias. JACC Clin Electrophysiol. Published 24 September 2025. doi:10.
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