Catheter Ablation of an Accessory Pathway within the Marshall Vein in a Patient with Mechanical Mitral Valve

Authors

  • AMIR ASLANI M.D.,

    1. Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran
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  • MEHDI MORADI M.D.,

    1. Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran
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  • JALAL KHEIRKHAH M.D.,

    1. Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran
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  • MAJID HAGHJOO M.D.

    Corresponding author
    • Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran
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  • Conflict of interest: None to declare.

Address for reprints: Majid Haghjoo, M.D., F.A.C.C., F.E.S.C., Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Mellat Park, Vali-E-Asr Avenue, Tehran 1996911151, Iran. Fax: 98 21 2204 8174; e-mail: majid.haghjoo@gmail.com

Abstract

A 37-year-old man, known case of mitral valve replacement, was referred for ablation. Meticulous mapping showed the earliest signal in the distal coronary sinus (CS). Endocardial ablation via transseptal approach failed to permanently ablate the accessory pathway. Similarly, ablation within the CS was unsuccessful. Finally, the mapping catheter was introduced into the vein of Marshall (VoM) and a very early signal was obtained. In the first 3 seconds of the radiofrequency energy application within the VoM, delta wave disappeared. During 1-year follow-up, the patient had no recurrence of the palpitations and electrocardiogram showed no delta wave. (PACE 2013; 36:e132–e135)

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