Ethanol infusion added to vein ablation for recurrent atrial fibrillation
Tests added ethanol infusion with vein ablation in adults with recurring atrial fibrillation.
Plain-language title generated from the registry record
Registry title: Added Value of Vein of Marshal Ethanol Infusion Compared to Superior Vena Cava Isolation Alone in Patients Undergoing Repeat Ablation for Recurrent Paroxysmal Atrial Fibrillation Despite Durable PV Isolation
Key facts
- Where
- Bruges, BelgiumSee the site
Where in Belgium
- AZ Sint-Jan Brugge-Oostende AVBruges, BelgiumTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- AZ Sint-Jan AV
- Trial code
- NCT04529785
- Record updated
- 12 May 2026
- Original description
The superior vena cava (SVC) is one of the most common non pulmonary vein (PV)-triggers for atrial tachyarrhythmias. SVC electrical isolation can be reached by circular radiofrequency (RF)-ablation under close monitoring of the phrenic nerve. However, adding substrate modification and vein of Marshal (VoM) ethanol infusion to the ablation procedure might substantially improve long-term outcomes.Read full original descriptionShow less
Added Value of Vein of Marshal Ethanol Infusion Compared to Superior Vena Cava Isolation Alone in Patients Undergoing Repeat Ablation for Recurrent Paroxysmal Atrial Fibrillation Despite Durable Pulmonary Vein Isolation
The superior vena cava (SVC) is one of the most common non pulmonary vein (PV)-triggers for atrial tachyarrhythmias. SVC electrical isolation can be reached by circular radiofrequency (RF)-ablation under close monitoring of the phrenic nerve. However, adding substrate modification and vein of Marshal (VoM) ethanol infusion to the ablation procedure might substantially improve long-term outcomes.
The aim of this study is to evaluate the recurrence rate 1 year after the index ablation in patients undergoing a redo ablation for recurrent paroxysmal atrial fibrillation (PAF) despite durable pulmonary vein isolation (PVI) with either SVC isolation alone or with substrate modification including vein of Marshal ethanolisation in addition to SVC isolation alone
Inclusion: Patients older than 18 years; Patients scheduled for a repeat ablation of PAF after a previous PVI; Confirmation of lasting pulmonary vein isolation at the time of randomization.
Exclusion: Previous ablation with isolation of the SVC, roofline, mitral line or previous vein of Marshal ethanol infusion; Cardiac surgery within the previous 90 days; Coronary percutaneous transluminal coronary angioplasty/stenting within the previous 90 days or myocardial infarction within the previous 60 days; Documented history of a thromboembolic event within the previous 90 days; Patient cannot be removed from antiarrhythmic drugs for reasons other than AF; Expecting cardiac transplantation or other cardiac surgery within 180 days; Significant restrictive, constrictive, or chronic obstructive pulmonary disease with chronic symptoms; Acute illness or active infection at time of index procedure; Advanced renal insufficiency; Unstable angina; History of blood clotting or bleeding abnormalities; Presence of a condition that precludes vascular access; Left ventricular ejection fraction <35%; Patients with persistent atrial fibrillation; Left atrial thrombus. Left atrial appendage thrombus can be determined by preprocedural imaging: CT, transesophageal echocardiography or MRI; Diagnosed atrial myxoma; Significant congenital anomaly or medical problem that in the opinion of the investigator would preclude enrollment; Women who are pregnant or who plan to become pregnant during the study; Contraindication to anticoagulation; Life expectancy less than 1 year; International Normalized Ratio greater than 3.5 within 24 hours of procedure - for patients taking warfarin; Unwilling or unable to provide informed consent.