Vein of Marshall Activity During Sustained Atrial Fibrillation

Kamanu, Santosh; Tan, Alex Y.; Peter, C. Thomas; Hwang, Chun; Chen, Peng‐Sheng

doi:10.1111/j.1540-8167.2006.00516.x

Cited by 54 publications

(46 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, a very rapid focus producing fibrillatory conduction may be a driver of AF, and these drivers are often the targets of the catheter ablation 23,24. Animal and human studies have shown that the MB had the highest dominant frequency during sustained AF 10,11. The complex pattern of the electroanatomical connections between the MB and the LA can provide a substrate for re-entry, leading to complex and fragmented MB activities.…”

Section: Discussionmentioning

confidence: 99%

“…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. We hypothesize that the presence of multiple connections between MB and LA allow re-entrant excitations to occur between them, leading to more complex and rapid activations that help maintenance of the AF.…”

mentioning

confidence: 94%

See 1 more Smart Citation

Electrophysiological characteristics of the Marshall bundle in humans

et al. 2010

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 94%

Electrophysiological characteristics of the Marshall bundle in humans

et al. 2010

Self Cite

View full text Add to dashboard Cite

show abstract

“…Their relevance extends beyond that of being mere embryological remnants of a left superior vena cava, since they have been implicated in the pathogenesis of atrial fibrillation (AF), both as a source of initiating triggers, 1 as well as a vehicle of parasympathetic 2 and sympathetic 3 innervations that modulate electrical properties of atrial tissue and contribute to AF maintenance. 4 These properties make the VOM an attractive target during ablation of atrial arrhythmias. Here we review the anatomical and physiological underpinnings of VOM-related arrhythmogenesis and the data that support targeting it for therapeutic purposes.…”

Section: Introductionmentioning

confidence: 99%

Ligament and vein of Marshall: A therapeutic opportunity in atrial fibrillation

2016

View full text Add to dashboard Cite

“…(9) These properties make the VOM an attractive target during ablation of AF. Furthermore, the location of the VOM in the left atrium (LA), running in the epicardial aspect of the lateral ridge (thick pectinate muscle between the left pulmonary veins and the LA appendage), and running along the postero-lateral LA towards the annulus (coronary sinus) coincides with LA regions usually ablated during catheter ablation of AF.…”

Section: Introductionmentioning

confidence: 99%