Ethanol Infusion via the Vein of Marshall for Focal Left Atrial Appendage Atrial Tachycardia

BACKGROUND: Focal atrial tachycardia (AT) originating from the left atrial appendage (LAA) presents clinical challenges. CASE SUMMARY: The patient was a 45-year-old man who presented with drug-refractory AT. Activation mapping indicated focal AT originating from the LAA, and endocardial ablation failed. Ethanol infusion via the vein of Marshall (VOM) terminated the focal AT. DISCUSSION: This is to our knowledge the first report of ethanol ablation via the VOM as an approach when endocardial ablation fails. TAKE-HOME MESSAGE: Ethanol infusion via the VOM can be a viable method to eliminate focal AT originating from the LAA.