Disclosures: The study received no industry support.
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Electrical Isolation of Both Left Pulmonary Veins by a Single Left Atrial Endocardial Radiofrequency Energy Application: Ablation of Marshall Bundle Bypass
Article first published online: 1 APR 2012
DOI: 10.1111/j.1540-8159.2012.03369.x
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
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How to Cite
VARMA, N. and ABI-SALEH, B. (2012), Electrical Isolation of Both Left Pulmonary Veins by a Single Left Atrial Endocardial Radiofrequency Energy Application: Ablation of Marshall Bundle Bypass. Pacing and Clinical Electrophysiology, 35: e325–e329. doi: 10.1111/j.1540-8159.2012.03369.x
Publication History
- Issue published online: 7 NOV 2012
- Article first published online: 1 APR 2012
- Received January 25, 2011; revised August 10, 2011; accepted December 3, 2011.
- Abstract
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Keywords:
- ablation;
- pulmonary vein isolation;
- atrial fibrillation;
- Marshall bundle
The muscular sleeve contained within the ligament of Marshall (Marshall Bundle, MB) has been implicated in triggering and/or maintaining atrial fibrillation. Its connections may form a conduit between the left atrium (LA) and the left pulmonary veins (PVs) and challenge PV isolation attempts. In this case, radiofrequency (RF) ablation at antra of both left PVs failed to affect venous electrical activity. However, isolation of both PVs occurred simultaneously with a single, short (14 seconds) RF energy application at the mitral isthmus. This was delivered at a site recording a complex continuous electrogram (duration 100 ms), interpreted as the site of a single connection between LA and MB. (PACE 2012; 35:e325–e329)