Impact of Technique and Technology on Mitral Isthmus Ablation

Aditi Naniwadekar, Jacob Koruth

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


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.

Original languageEnglish
Article number46
JournalCurrent Treatment Options in Cardiovascular Medicine
Issue number9
StatePublished - 1 Sep 2019


  • Coronary sinus balloon occlusion
  • Mitral isthmus ablation
  • Mitral isthmus block
  • Vein of Marshall ablation


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