Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center and Houston Methodist Research Institute, The Methodist Hospital, Houston, Texas.
Heart Rhythm. 2021 Jul;18(7):1074-1082. doi: 10.1016/j.hrthm.2021.03.032. Epub 2021 Mar 26.
The vein of Marshall (VOM) contains innervation, myocardial connections, and arrhythmogenic foci that make it an attractive target in catheter ablation of atrial fibrillation (AF). Additionally, it co-localizes with the mitral isthmus, which is critical to sustain perimitral flutter, and is a true atrial vein that communicates with underlying myocardium. Retrograde balloon cannulation of the VOM from the coronary sinus is feasible and allows for ethanol delivery, which results in rapid ablation of neighboring myocardium and its innervation. Here we review the body of work performed over a span of 13 years, from the inception of the technique, to its preclinical validation, to demonstration of its ablative and denervation effects, and finally to completion of a randomized clinical trial demonstrating favorable outcomes, improving rhythm control in catheter ablation of persistent AF.
马歇尔静脉（VOM）含有神经支配、心肌连接和心律失常灶，使其成为房颤（AF）导管消融的一个有吸引力的靶点。此外，它与二尖瓣峡部共定位，这对于维持二尖瓣环扑动至关重要，并且是与下心肌沟通的真正心房静脉。从冠状窦逆行球囊插管 VOM 是可行的，并允许乙醇输送，这导致邻近心肌及其神经支配的快速消融。在这里，我们回顾了 13 年来完成的工作，从技术的初始阶段到临床前验证，再到证明其消融和去神经作用，最后完成了一项随机临床试验，证明了有利的结果，改善了持续性房颤导管消融的节律控制。
