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. Author manuscript; available in PMC: 2016 Jul 1.
Published in final edited form as: Curr Opin Cardiol. 2015 Jul;30(4):333–343. doi: 10.1097/HCO.0000000000000183

Table 2.

Results of transcoronary arterial ethanol ablation of ventricular tachycardia

Study
reference
Year Study
design
Patients
(n)
Age
(years)
Indications Follow-up Results Complications Observations
Brugada
et al. [24]
1989 Intracoronary 96%
 ethanol injection
3 44, 61, 62 Incessant tachycar-
 dia postmyocar-
 dial infarction
2–9 months
 (mean 5.7)
Cease of arrhythmia in
 100% (one recur-
 rence at 1 month,
 repeating procedure
 successfully)
Short-lasting chest pain in
 all the patients
Chemical ablation of
 the arrhythmogenic
 resulted in cure of the
 disorder. Size of the
 ablation should be as
 limited as possible.
Temporary complete AV
 block with pacemaker
 implantation in 1
 patient (33%)
New collateral blood
 supply may lead to
 recurrence.
Small to moderate AST
 rise

Kay
et al. [25]
1992 Intracoronary 96%
 ethanol injection
23 (10
 received
 ethanol)
59 ± 12 Sustained monomor-
 phic ventricular
 tachycardia
 related to prior MI
102–788
 days
 (mean 372)
Cease in 100%, with
 inducible VT in 3
 patients (30%)
Complete AV block in 4
 patients (40%)
Moderate degree of
 efficacy and potential
 for complications. Lo-
 ng-term control for
 particular patients.
 Limited by the fre-
 quent inability to
 localize the arrhyth-
 mia-related vessel.
Little or no change in
 LVEF.
Pericarditis (Dressler’s
 syndrome) in 1 patient
 (10%)

Tokuda
et al. [28]
2011 Intracoronary 96%
 ethanol injection
27 – out
 of these,
 22 received
 ethanol
63 ± 13 Symptomatic mono-
 morphic VT refrac-
 tory to RFA;
 structural heart
 disease
20 ± 11
 months
VT was no inducible
 after ablation in 18
 patients (82%)
Complete heart block in
 5 patients (38% of 13
 patients with intact AV
 conduction)
Important role for diffi-
 cult VTs in high-risk
 patients. Prevents
 recurrences in 36%
 and improves arrhyth-
 mia control in an
 additional 27%.
VT recurrence in 14
 patients (64%)
Temporary coronary
 spasm 1 patient (5%)
Nine out of 11 were
 free from VT storm
Total mortality 32%, early
 mortality (within 30
 days) 14% and late
 mortality 18%
CK, CK-MB and Trop I
 elevation

Sacher
et al. [32]
2008 Intracoronary 96%
 ethanol injection
9 55 ± 9 Refractory monomor-
 phic VT due to
 scar-related re-
 entry; ischemic
 cardiomyopathy
 in 6 patients
 (67%)
29 ± 23
 months
No VT recurrence in
 67%
Transient ST-elevation
 during injection in 5
 patients (55%)
Applicable alternative
 especially in cases of
 septal scar (VT cir-
 cuits deep intramyo-
 cardial). TCEA rarely
 used (1.4%).
No significant change
 in LVEF
Immediate: transient
 severe hypotension in
 2 patients (22%) and
 bilateral groin hemato-
 mas in 1 patient (11%)
CK-MB and Trop. I rise
 with injection
-Three patients died in the
 follow-up from refrac-
 tory HF (33%).

AST, aspartate aminotransferase; AV, Atrioventricular; CK, creatine kinase; CK-MB, creatine kinase MB; HF, heart failure; LVEF, Left ventricular ejection fraction; RFA, radiofrequency ablation; TCEA, transcoronary ethanol ablation; Trop. I, troponin I; VT, ventricular tachycardia.