Cheng Shilin, Yin Jie, Li Xinran, Wang Yu, Hu Hesheng
Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250000, P.R. China.
Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial QianFoshan Hospital, Jinan, Shandong 250014, P.R. China.
Biomed Rep. 2025 Jul 17;23(3):153. doi: 10.3892/br.2025.2031. eCollection 2025 Sep.
Atrial fibrillation (AF) is a common arrhythmia that usually coexists with heart failure (HF). However, research into the efficacy and safety of catheter ablation with vein of Marshall ethanol infusion (VOM-EI) in patients with persistent AF and HF with reduced ejection fraction (HFrEF) is limited. In the present study, a single-center retrospective study was conducted, involving 85 patients with persistent AF and HFrEF. Patients in group A (n=40; male/female: 29/11; average age: 62.33±11.50 years) received catheter ablation plus VOM-EI treatment, while patients in group B (n=45; male/female: 34/11; average age: 59.36±10.91 years) received catheter ablation only. The study compared the two groups regarding primary endpoint events (rate of restoration of sinus rhythm after surgery and rate of postoperative AF recurrence) and secondary endpoint events [cardiac function parameters (left ventricular ejection fraction (LVEF), left atrium diameter (LAD), left ventricular end diastolic volume (LVEDV)], New York Heart Association (NYHA) classification, B-type natriuretic peptide (BNP) and rate of postoperative rehospitalization] at 6 months of follow-up. Surgery duration and perioperative adverse events were also compared between the two groups. There were no statistical differences in baseline characteristics, CHA2DS2-VASc score and HAS-BLED score between the two groups. In comparison with group B, group A had a decreased rate of postoperative AF recurrence (2.78 vs. 21.05%). Compared with preoperative levels, both groups achieved significant enhancement in postoperative LVEF, LVEDV and LAD. Group A exhibited a significantly greater improvement in postoperative LVEF, NYHA classification and BNP levels compared with group B. No significant differences were observed between the two groups in the rate of sinus rhythm restoration (90.0 vs. 84.44%) and the rate of postoperative rehospitalization (2.78 vs. 15.79). In addition, group A exhibited a significantly shorter surgical duration than group B (156.78±39.36 min vs. 181.73±52.39 min). There were no statistically significant differences in the rate of perioperative adverse events between the two groups (7.5 vs. 8.89%). In summary, the use of VOM-EI in conjunction with catheter ablation is a safe and effective strategy for treating patients with persistent AF and HFrEF. This approach results in effective cardiac function restoration, lower postoperative AF recurrence rate, and shorter surgical time.
心房颤动（AF）是一种常见的心律失常，通常与心力衰竭（HF）并存。然而，关于Marshall静脉乙醇注入（VOM-EI）导管消融术在持续性AF和射血分数降低的心力衰竭（HFrEF）患者中的疗效和安全性的研究有限。在本研究中，进行了一项单中心回顾性研究，纳入了85例持续性AF和HFrEF患者。A组（n = 40；男/女：29/11；平均年龄：62.33±11.50岁）患者接受导管消融加VOM-EI治疗，而B组（n = 45；男/女：34/11；平均年龄：59.36±10.91岁）患者仅接受导管消融治疗。该研究比较了两组在主要终点事件（术后窦性心律恢复率和术后AF复发率）和次要终点事件[心功能参数（左心室射血分数（LVEF）、左心房直径（LAD）、左心室舒张末期容积（LVEDV）]、纽约心脏协会（NYHA）分级、B型利钠肽（BNP）和术后再住院率）方面的情况，随访时间为6个月。还比较了两组的手术时间和围手术期不良事件。两组在基线特征、CHA2DS2-VASc评分和HAS-BLED评分方面无统计学差异。与B组相比，A组术后AF复发率降低（2.78%对21.05%）。与术前水平相比，两组术后LVEF、LVEDV和LAD均显著提高。与B组相比，A组术后LVEF、NYHA分级和BNP水平改善更显著。两组在窦性心律恢复率（90.0%对84.44%）和术后再住院率（2.78%对15.79%）方面无显著差异。此外，A组的手术时间明显短于B组（156.78±39.36分钟对181.73±52.39分钟）。两组围手术期不良事件发生率无统计学差异（7.5%对8.89%）。总之，VOM-EI联合导管消融术是治疗持续性AF和HFrEF患者的一种安全有效的策略。这种方法可有效恢复心功能，降低术后AF复发率，并缩短手术时间。
