TY - JOUR
T1 - Impact of Technique and Technology on Mitral Isthmus Ablation
AU - Naniwadekar, Aditi
AU - Koruth, Jacob
N1 - Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Purpose of review: Mitral isthmus ablation is an established strategy in the treatment of peri-mitral atrial flutter and as an adjunct to pulmonary vein isolation. The objective of this review is to summarize the techniques and specific strategies that allow for increased success and durability of mitral isthmus ablation. Recent findings: Achieving bidirectional block across the mitral isthmus remains a challenge due to the increased thickness in this region, convective cooling as a result of coronary sinus blood flow, and the occurrence of epicardial connections. Several strategies to achieve durable mitral isthmus block, such as coronary sinus ablation, coronary sinus balloon occlusion, ethanol ablation via the vein of Marshall, and using alternate mitral lines in select cases, are described in detail in this review.
AB - Purpose of review: Mitral isthmus ablation is an established strategy in the treatment of peri-mitral atrial flutter and as an adjunct to pulmonary vein isolation. The objective of this review is to summarize the techniques and specific strategies that allow for increased success and durability of mitral isthmus ablation. Recent findings: Achieving bidirectional block across the mitral isthmus remains a challenge due to the increased thickness in this region, convective cooling as a result of coronary sinus blood flow, and the occurrence of epicardial connections. Several strategies to achieve durable mitral isthmus block, such as coronary sinus ablation, coronary sinus balloon occlusion, ethanol ablation via the vein of Marshall, and using alternate mitral lines in select cases, are described in detail in this review.
KW - Coronary sinus balloon occlusion
KW - Mitral isthmus ablation
KW - Mitral isthmus block
KW - Vein of Marshall ablation
UR - http://www.scopus.com/inward/record.url?scp=85069691445&partnerID=8YFLogxK
U2 - 10.1007/s11936-019-0752-1
DO - 10.1007/s11936-019-0752-1
M3 - Review article
AN - SCOPUS:85069691445
VL - 21
JO - Current Treatment Options in Cardiovascular Medicine
JF - Current Treatment Options in Cardiovascular Medicine
SN - 1092-8464
IS - 9
M1 - 46
ER -