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Introduction <p>Managing recurrent atrial flutter (AFL) following radiofrequency ablation (RFA) for atrial fibrillation (AF) poses significant clinical challenges.</p> Methods and results <p>We report an 82-year-old male with mirror-image dextrocardia who developed AFL post-AF ablation. During the redo procedure, vein of Marshall ethanol infusion (VOM-Et) was employed as the initial intervention, successfully terminating the mitral isthmus (MI)-dependent AFL and transitioning into cavotricuspid isthmus (CTI)-dependent AFL during ethanol infusion. Subsequent ablation restored sinus rhythm.</p> Conclusion <p>Using VOM-EI as the initial intervention in patients with recurrent AFL is a feasible and safe approach, and to our knowledge, this represents the first reported case of VOM-EI in a patient with recurrent AFL in the setting of dextrocardia.</p>

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Vein of Marshall ethanol infusion for recurrent atrial flutter after ablation in a patient with dextrocardia

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  • 发表日期：

    2025年4月24日

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  • Zikan Zhong,
  • Xiaoyu Wu,
  • Jie An,
  • Qitong Zhang,
  • Cheng Cheng,
  • Yong Wei,
  • Songwen Chen,
  • Shaowen Liu,
  • Genqing Zhou

摘要

Introduction

Managing recurrent atrial flutter (AFL) following radiofrequency ablation (RFA) for atrial fibrillation (AF) poses significant clinical challenges.

Methods and results

We report an 82-year-old male with mirror-image dextrocardia who developed AFL post-AF ablation. During the redo procedure, vein of Marshall ethanol infusion (VOM-Et) was employed as the initial intervention, successfully terminating the mitral isthmus (MI)-dependent AFL and transitioning into cavotricuspid isthmus (CTI)-dependent AFL during ethanol infusion. Subsequent ablation restored sinus rhythm.

Conclusion

Using VOM-EI as the initial intervention in patients with recurrent AFL is a feasible and safe approach, and to our knowledge, this represents the first reported case of VOM-EI in a patient with recurrent AFL in the setting of dextrocardia.