Venous Ethanol Ablation Approaches for Radiofrequency-Refractory Cardiac Arrhythmias

PURPOSE OF REVIEW: In this review, we summarize the procedural approach and outcomes of venous ethanol infusion in the treatment of ventricular arrhythmias with intramural site of origin.

RECENT FINDINGS: Coronary venous ethanol infusion has emerged as a novel, safe, and effective adjunctive strategy to radiofrequency ablation of drug refractory ventricular arrhythmias with an intramural origin. Radiofrequency catheter ablation is the first-line treatment for drug refractory ventricular arrythmias. Its success is highly dependent on the ability to reach targeted myocardium. Radiofrequency failures are common in patients with ventricular arrhythmias arising from deep intramural substrates, and those whose origin is in close proximity to vital structures such as coronary arteries or the phrenic nerve. Coronary venous ethanol infusion has emerged as a novel technique that circumvents these limitations.