Anyone here have experience with Vein of Marshall alcohol ablation?
So I'm looking at my 6th ablation, yes 6.My history goes like this. I am an avid cyclist and developed typical atrial flutter about 12 years ago. Had a cardicoversion that lasted all but 24 hours. next I had an ablation and was good for about 16 months before the typical flutter returned. Typical flutter is usually a one time occurance. Got another ablation was good for maybe 2 years then fib started. had another ablation and the recovery was hell - took 5 months but in hte end I was good for 5 years. Dec. 2024 the devil returned. I had a cardioversion and was good for 8 months even went skiing in Austria. Sept. 2025 flutter returned. The EP told me about PWA and how great it was. he kept saying the flutter was going to keep coming back and at closer intervals. I was hesitant but in Dec 2025 I went into the lab in NSR had the ablation and before I left the hospital I was in flutter. Had a cardioversion 10 days later and it lasted 4 days. My EP and I talked at great extent and he offered t odo another ablation using PWA and isoproterenol. I did it again on 1-30-2026. Was good for about 10 days and now it's back. I spoke with him and was told about the Vein of Marshal. Did my research on Pub Med etc and see that is has been successful in perimitral flutter which is my current Dx. My EP told me he would refer me anywhere I wanted and even recommended Dr. Mathew Cain in St. Helena. Dr. Cain has done some of the VOM. I checked out UCSF and found Dr. Gerstenfeld has done the VOM's as well. I'm really at a loss of where to go and who to pick. Keep in mind the ablation business in a 6 billion dollar a year industry. I watched Dr. Lee's stuff but my questions were not answered. Met with my EP today and discussed the situation. He has 28 years experience and trained at Cleveland Clinic for his Fellowship. Today he expelained the PWA is a flower shape which I knew but is not as pinpoint as RF so it's really a shotgun approach to cover a lot of area so faster for the provider which menas more cases completed in a day and of course more income for the provider and the facility. I was also told by my EP that PWA bc it's electric energy doing the ablation that you can get unintentionally cardioverted during the procedure and the provider will think they got the roughe cells but are tricked by unintetional cardioversion. Any help is appreciated. Sometime a 45 to through the mouth aimed at the brainstem seems a good solution. This fib is like the devil having a hold of you.
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Welcome to the Club....of tachyarrhythmia sufferers. Mine is AF, ablated twice, second one has been working 37 months now. I have done a lot of reading and studying, but not so much about the other arrythmias and VoM treatment. I do know about it, but haven't pursued it intellectually.
Dr. Lee insists that flutter is about 95% treatable with ablation, but that niggling 5% is worrying...for both of us.
The two best EPs I know of, being a frequenter of two fora on AF (not so much about flutter, but the two are 'kissin' cousins'), and I'm in Canada...so this is what some other forumites rave about...are Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin and Dr. Pasquale Santangeli at Cleveland. I do not know if they do/support VoM ablation, but it would be worth a phone call....surely. Natale's office is 512-544-2342. He travels widely, has privileges at several hospitals, and gives appearances and lectures, even in EU. He was trained by Dr. Pierre Jais at the Bordeaux arrhythmia clinics, pretty much the Great Guru of heart arrhythmias and their management. And, if Natale doesn't do VoM, he may know The Guy...or The Gal.
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1 ReactionThank you I'll give them a call!!!