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Acute Nonsustained Mitral Isthmus Block Obtained With Sphere-9 Lattice-Tip Catheter Completed With Vein of Marshall Ethanol Infusion.

J Cardiovasc Electrophysiol

January 2025

Hôpital Cardiologique du Haut Léveque, CHU de Bordeaux, L'Institut de RYthmologie et modelisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.

Background: Achieving a durable mitral line block using radiofrequency as a part of an anatomical approach for ablation in patients with persistent atrial fibrillation or for treating peri-mitral flutter has always been challenging due to the complex anatomy of the mitral isthmus. Epicardial ablation via the coronary sinus and the vein of Marshall has been proposed to help create durable lesions. Recently, a novel lattice-tip catheter using pulsed field ablation has shown promising results for creating mitral lines, despite limited data.

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This study evaluated transcatheter approach for relieving right ventricular outflow tract (RVOT) obstruction using combined non-compliant balloon dilatation of the RVOT and conal artery occlusion in patients with Tetralogy of Fallot (TOF), both uncorrected and post-intra-cardiac repair (ICR) restenosis. A prospective study was conducted from January 2022 to June 2023, including 40 symptomatic patients aged over 12 years with RVOT obstruction in TOF. Exclusion criteria included moderate to severe pulmonary regurgitation.

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Since its first pathological description over 65 years ago, hypertrophic cardiomyopathy (HCM), with a worldwide prevalence of 1:500, has emerged as the most common genetically determined cardiac disease. Diagnostic work-up has dramatically improved over the last decades, from clinical suspicion and abnormal electrocardiographic findings to hemodynamic studies, echocardiography, contrast-enhanced cardiac magnetic resonance, and genetic testing. The implementation of screening programs and the use of implantable cardioverter defibrillators (ICDs) for high-risk individuals have notably reduced arrhythmic sudden deaths, altering the disease's mortality profile.

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Background: Primary hyperparathyroidism (pHPT) is the third most common endocrine system disorder. Parathyroidectomy (PTx) is the gold standard of care in symptomatic patients. Patients who are not surgical candidates may benefit from percutaneous ethanol ablation, which is a minimally invasive procedure.

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