Ligament of Marshall ablation for persistent atrial fibrillation.
ligament of marshall
marshall bundle
pulmonary vein isolation
vein of marshall
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
revised:
09
02
2021
received:
03
08
2020
accepted:
28
02
2021
pubmed:
10
3
2021
medline:
20
1
2022
entrez:
9
3
2021
Statut:
ppublish
Résumé
Beyond pulmonary vein isolation, the two main additional strategies: Cox-Maze procedure or targeting of electrical signatures (focal bursts, rotational activities, meandering wavelets), remain controversial. High-density mapping of these arrhythmias has demonstrated firstly that a patchy lesion set is highly proarrhythmogenic, favoring macro-re-entry through conduction slowing and providing pivots for localized re-entry. Secondly, discrete anatomical structures such as the Vein or Ligament of Marshall (VOM/LOM) and the coronary sinus (CS) have epicardial muscular bundles that are more frequently involved in re-entry than previously thought. The Marshall Bundle can be ablated at any point along its course from the mid-to-distal coronary sinus to the left atrial appendage. If necessary, the VOM may be directly ablated using ethanol infusion to eliminate PV contributions and produce conduction block across the mistral isthmus. Ethanol ablation of the VOM, supplemented with RF ablation, may be more effective in producing conduction block at the mitral isthmus than repeat RF ablation alone.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
782-791Informations de copyright
© 2021 Wiley Periodicals LLC.
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