Alcohol Ablation of Vein of Marshall Proves Beneficial in Atrial Fibrillation

Ablation of atrial fibrillation (AF) has become commonplace. While the technique for treating paroxysmal AF is relatively well established, ablation of persistent AF has a success rate far lower than we would like. This has led to an abundance of ablative techniques, none of which has become standard of care. To evaluate whether ablating the vein of Marshall would help patients with persistent AF, investigators performed a randomized, controlled trial in 350 patients. The vein of Marshall is the vestigial left superior vena cava, lies near the left pulmonary veins, and, like the pulmonary veins, may contain triggers of AF.

The study arms were catheter ablation alone or with alcohol ablation of the vein of Marshall. Most patients (>95%) recei…