Evaluating Vein of Marshal Ethanol Infusion Added to Superior Vena Cava Isolation for Repeat Ablation in Paroxysmal Atrial Fibrillation Patients with Lasting Pulmonary Vein Isolation

What this Trial Is About

Researchers are evaluating treatments for patients with paroxysmal atrial fibrillation PAF who experience recurrence despite durable pulmonary vein isolation PVI. The study aims to compare the rate of atrial tachyarrhythmia recurrence one year after repeat ablation procedures that either isolate the superior vena cava SVC alone or combine SVC isolation with additional substrate modification including vein of Marshal ethanol infusion. This study focuses on improving long-term outcomes for patients undergoing redo ablation for recurrent PAF. Participants are randomly assigned to one of two groups. One group receives radiofrequency RF ablation with isolation of the SVC alone. The other group receives RF ablation with isolation of the SVC plus substrate modification and vein of Marshal ethanol infusion. Both procedures are performed during the repeat ablation session. The study evaluates these two approaches to identify potential benefits of adding the vein of Marshal ethanol infusion. During the study, participants are monitored for recurrence of atrial tachyarrhythmia one year after their ablation. Safety is also assessed during the procedure by tracking complications. Additional measures include total procedural time, fluoroscopy time, and RF ablation time. Participants will undergo preprocedural imaging to confirm lasting pulmonary vein isolation. The study duration extends through follow-up assessments for up to one year to evaluate outcomes and safety.

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