Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037, China.
National Center for Clinical Laboratories, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, National Center of Gerontology, Beijing, China.
BMC Cardiovasc Disord. 2023 Oct 24;23(1):516. doi: 10.1186/s12872-023-03553-9.
The vein of Marshall (VOM) ethanol infusion is increasingly performed in combination with catheter ablation in atrial fibrillation (AF). The cannulation of the VOM can sometimes be challenging. This study aimed to evaluate the double-wire technique in cases of difficult cannulation of the VOM.
Patients with AF scheduled for combined catheter ablation and VOM ethanol infusion were consecutively enrolled. The procedure was performed via the femoral vein. If the regular cannulation technique with one angioplasty wire failed or took more than 20 min, the double-wire technique using a stabilizing wire and a cannulation wire was performed. The unique technique was used mainly in two scenarios, when the Eustachian ridge was too prominent as a barrier for catheter manipulation or when the VOM ostium was close to the coronary sinus ostium. Of 162 patients scheduled for VOM ethanol infusion, the double-wire technique was applied in 6 (3.7%) patients and led to a 100% successful cannulation rate of the VOM. Of the six patients, two had a prominent Eustachian ridge, and four had a VOM ostium close to the coronary sinus ostium. The mean cannulation time was 33.3 ± 7.3 min. The ethanol infusion was successfully performed in 5 patients. One patient had a collateral circulation in the distal VOM, and ethanol infusion was not performed.
The double-wire technique can facilitate VOM cannulation and ethanol infusion in challenging cases.
Marshall 静脉（VOM）乙醇输注越来越多地与房颤（AF）导管消融联合进行。VOM 的插管有时会具有挑战性。本研究旨在评估在 VOM 插管困难的情况下使用双丝技术。
连续招募了计划进行导管消融联合 VOM 乙醇输注的 AF 患者。该程序通过股静脉进行。如果常规使用一根血管成形术导丝的插管技术失败或耗时超过 20 分钟，则使用稳定导丝和插管导丝的双丝技术进行。该独特技术主要用于两种情况，即当耳咽管嵴过于突出成为导管操作的障碍，或者当 VOM 口接近冠状窦口时。在 162 名计划进行 VOM 乙醇输注的患者中，有 6 名（3.7%）患者使用了双丝技术，VOM 的插管成功率达到了 100%。这 6 名患者中，有 2 名患者的耳咽管嵴突出，4 名患者的 VOM 口接近冠状窦口。平均插管时间为 33.3±7.3 分钟。5 名患者成功进行了乙醇输注。1 名患者 VOM 远端有侧支循环，未进行乙醇输注。
双丝技术可在困难情况下促进 VOM 插管和乙醇输注。
231 个。
