title: Ethanol for the treatment of cardiac arrhythmias.
abstract: BACKGROUND
  Ethanol infusion was an early mode of ablative treatment for cardiac arrhythmias. Its initial descriptions involved coronary intra-arterial delivery, targeting arrhythmogenic substrates in drug-refractory ventricular tachycardia or the atrioventricular node. Largely superseded by radiofrequency ablation (RFA) and other contact-based technologies as a routine ablation strategy, intracoronary arterial ethanol infusion remains as an alternative option in the treatment of ventricular tachycardia when conventional ablation fails. Arrhythmic foci that are deep-seated in the myocardium may not be amenable to catheter ablation from either the endocardium or the epicardium by RFA, but they can be targeted by an ethanol infusion.
  
  
  RESULTS
  Recently, we have explored ethanol injection through cardiac venous systems, in order to avoid the risks of complications and limitations of coronary arterial instrumentation. Vein of Marshall ethanol infusion is being studied as an adjunctive procedure in ablation of atrial fibrillation, and coronary venous ethanol infusion for ventricular tachycardia.
  
  
  CONCLUSIONS
  Ethanol ablation remains useful as a bail-out technique for refractory cases to RFA, or as an adjunctive therapy that may improve the efficacy of catheter ablation procedures.
authors.affiliation: Division of Cardiology, Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Schurmann
authors.forename: Jorge
authors.initials: J
authors.lastname: Peñalver
authors.forename: Miguel
authors.initials: M
authors.lastname: Valderrábano
mesh_terms: D003331:Coronary Vessels; D000431:Ethanol / Q000008:administration & dosage*; D006801:Humans; D007261:Infusions, Intra-Arterial; D017180:Tachycardia, Ventricular / Q000188:drug therapy*
chemical_list: D000431:Ethanol