Demonstration of Electrical and Anatomic Connections Between Marshall Bundles and Left Atrium in Dogs: Implications on the Generation of P Waves on Surface Electrocardiogram

Omichi, Chikaya; Chou, Chung-Chuan; Lee, Moon Hyoung; Chang, Chun‐Hsiang; Lai, Chi; Hayashi, Hideki; Zhou, Shengmei; Miyauchi, Yasushi; Okuyama, Yuji; Hamabe, Akira; Hwang, Chun; Fishbein, Michael C.; Lin, Shien‐Fong; Karagueuzian, Hrayr S.; Chen, Peng‐Sheng

doi:10.1046/j.1540-8167.2002.01283.x

Cited by 26 publications

(28 citation statements)

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“…Because there is no other connection between the MB and LA, the MB was not pre-excited by the sinus wavefront from the Bachmann bundle 6. This type of connection has also been previously documented in humans 9.…”

Section: Resultssupporting

confidence: 67%

“…The major connections are located in the CS juncture, LA–left PVs junction, and LA in between CS and PVs with wide multiple connections. Studies in canine models showed that the MB provided an electrical conduit between LA–LLR and CS 6. Rapid activations from the MB indeed were sources of atrial tachycardia and AF in canine models and in humans,7–9 and rapid activation at the MB was also noted during persistent AF 10,11.…”

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confidence: 95%

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Electrophysiological characteristics of the Marshall bundle in humans

et al. 2010

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BACKGROUND Marshall bundles (MBs) are the muscle bundles within the ligament of Marshall. OBJECTIVE This trial sought to the electrophysiological characteristics of the MB and the anatomical connections between MB and left atrium (LA) in patients with persistent atrial fibrillation (AF). METHODS We enrolled 72 patients (male:female 59:13, age 59.9 ± 9.4 years) who underwent MB mapping and ablation for AF. MB mapping was done via an endocardial or epicardial approach during sinus rhythm and AF. RESULTS Recordings were successful in 64 of 72 patients (89%). A single connection was noted in 11 of 64 patients between the MB and the coronary sinus (CS) muscle sleeves. The MB recordings showed distinct MB potentials with a proximal-to-distal activation pattern during sinus rhythm. During AF, organized passive activations and dissociated slow MB ectopic activities were commonly observed in this type of connection. Double connections to both CS and LA around left pulmonary veins were noted in 23 of 64 patients (36%). After the ablation of the distal connection, MB recording showed typical double potentials as in single connection. Multiple connections were noted in 30 of 64 patients (47%). During sinus rhythm, the earliest activation was in the middle of the MB. The activation patterns were irregular and variable in each patient. During AF, rapid and fractionated complex activations were noted in all patients of this group. CONCLUSION We documented 3 different types of MB–LA connections. Rapid and fractionated activations were most commonly observed in the MB that had multiple LA connections.

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Section: Resultssupporting

confidence: 67%

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confidence: 95%

Electrophysiological characteristics of the Marshall bundle in humans

et al. 2010

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“…Although evidence of a histological connection between the MB and LA was presented in the study by Omichi et al, 15 during LA pacing large wavefronts also propagated from the pacing site and activated the LA without going through the MB. Doshi et al demonstrated that the conduction time from the atrial tissue to the LOM is short in dogs during isoproterenol infusion, but conduction in the reverse direction was slow and unreliable.…”

Section: Conduction Block Of the Histological Connection Between The mentioning

confidence: 94%

“…If the potential that was recorded over the LOM could be eliminated after ablation, it was considered to be a Marshall potential. 15 …”

Section: Epicardial Lom Ablationmentioning

confidence: 99%

“…12,15 First, the activation wavefront may proceed from the CS toward the LOM and then the Marshall potential may be separated from the atrial electrogram because the LA may be activated earlier for faster conduction velocity of Bachmann's bundle 15,16 ( Figure 8A). Second, if a histological connection of the MB and LA is present, the activation wavefront may proceed from Bachmann's bundle or the interatrial septum to the LOM through the histological connection 17 (Figure 8B).…”

Section: Diverse Lom Activation Under Sinus Rhythmmentioning

confidence: 99%

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Electrophysiological Characteristics of the Marshall Potential in Dogs Based on Anatomic Properties

Lei

Zhang

et al. 2009

Circ J

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Background:The electrophysiological characteristics of the Marshall potential is important in ligament of Marshall (LOM) ablation. Methods and Results: Marshall potential was recorded under sinus rhythm and left atrial appendage (LAA) pacing and in the first randomly selected 5 dogs (Group 1), LOM ablation was performed. Histological examination was performed in the remaining 10 dogs, which were subdivided according to the results (Groups 2, 3). During LAA pacing in Group 2, the AM interval was prolonged or shortened, whereas in Group 3 it was prolonged (125±9 vs 80±6 ms, P=0.043, when the pacing rate =350) (126±9 vs 80±6 ms, P=0.0442, when the pacing rate =450). The Marshall potential was separated from the atrial electrogram by LAA pacing in Groups 2 and 3. There was no significant difference in the AM interval during sinus rhythm and right atrial appendage pacing. Conclusions: Marshall potential has different forms on electrograms, including a prolonged AM interval, which presents with LAA pacing. This finding might be useful in LOM ablation. (Circ J 2009; 73: 444 -450)

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Electrocardiographic Characteristics of Atrial Fibrillation Initiators from the Thoracic Veins

Shah¹

2004

Thoracic Vein Arrhythmias

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Demonstration of Electrical and Anatomic Connections Between Marshall Bundles and Left Atrium in Dogs: Implications on the Generation of P Waves on Surface Electrocardiogram

Abstract: In about half of the normal dogs, MB provides an electrical conduit between LA free wall and CS. Severing MB alters the atrial activation and lengthens the P wave. MB contributes to generation of the P wave on surface ECG.

Cited by 26 publications

References 5 publications

Electrophysiological characteristics of the Marshall bundle in humans

Electrophysiological characteristics of the Marshall bundle in humans

Electrophysiological Characteristics of the Marshall Potential in Dogs Based on Anatomic Properties

Electrocardiographic Characteristics of Atrial Fibrillation Initiators from the Thoracic Veins

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