Atrial flutter following ethanol infusion in the vein of Marshall

Abstract

Key Teaching Points • The critical isthmus of atrial flutter, which is formed secondary to the low-voltage area created by ethanol infusion in the vein of Marshall (VOM), is rare. • It should be noted that although ethanol infusion in the VOM is effective for perimitral flutter, it may create another reentrant arrhythmia. • Additional radiofrequency catheter ablation from the endocardial side may prevent proarrhythmic effect.