Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation

Chun Hwang, Tsu Juey Wu, Rahul N. Doshi, C. Thomas Peter, Peng-Sheng Chen

Research output: Contribution to journalArticle

265 Citations (Scopus)

Abstract

Background - Whether or not the muscle bundle within the ligament of Marshall (LOM) can serve as the origin of focal atrial fibrillation (AF) is unknown. Methods and Results - A total of 28 consecutive patients with paroxysmal AF underwent balloon-occlusion coronary sinus angiograms to identify the vein of Marshall (VOM). Attempts were then made to advance a 1.5-French electrophysiological catheter into the VOM via the coronary sinus orifice. In 17 of the 28 patients (10 of 17 were men aged 38±15 years), cannulation was successful. Double potentials were registered in 8 of these 17 patients. The first potential corresponded with local left atrial activation. The second potential was shorter and narrower than the first. The sequence of activation in the second potential in the VOM was proximal to distal. In 6 patients with direct VOM recordings, we documented that the origin of AF was in the muscle bundle within the LOM. Radiofrequency catheter ablation aimed at the insertion site of the VOM successfully terminated AF in 4 of these 6 patients. Conclusions - (1) It is possible to cannulate and to record electrical potentials from the VOM. (2) The characteristics of the double potentials within the VOM suggest that the second potential is from the muscle bundle (Marshall bundle) within the LOM. (3) The Marshall bundle may be the origin of focal AF in some patients.

Original languageEnglish (US)
Pages (from-to)1503-1505
Number of pages3
JournalCirculation
Volume101
Issue number13
StatePublished - Apr 4 2000
Externally publishedYes

Fingerprint

Catheterization
Atrial Fibrillation
Veins
Ligaments
Coronary Sinus
Muscles
carbosulfan
Balloon Occlusion
Catheter Ablation
Angiography
Catheters

Keywords

  • Arrhythmias
  • Catecholamines
  • Catheter ablation
  • Electrophysiology
  • Potentials

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation. / Hwang, Chun; Wu, Tsu Juey; Doshi, Rahul N.; Peter, C. Thomas; Chen, Peng-Sheng.

In: Circulation, Vol. 101, No. 13, 04.04.2000, p. 1503-1505.

Research output: Contribution to journalArticle

Hwang, Chun ; Wu, Tsu Juey ; Doshi, Rahul N. ; Peter, C. Thomas ; Chen, Peng-Sheng. / Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation. In: Circulation. 2000 ; Vol. 101, No. 13. pp. 1503-1505.
@article{1f97aa69c6c44b96aa93f65e0ad0df97,
title = "Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation",
abstract = "Background - Whether or not the muscle bundle within the ligament of Marshall (LOM) can serve as the origin of focal atrial fibrillation (AF) is unknown. Methods and Results - A total of 28 consecutive patients with paroxysmal AF underwent balloon-occlusion coronary sinus angiograms to identify the vein of Marshall (VOM). Attempts were then made to advance a 1.5-French electrophysiological catheter into the VOM via the coronary sinus orifice. In 17 of the 28 patients (10 of 17 were men aged 38±15 years), cannulation was successful. Double potentials were registered in 8 of these 17 patients. The first potential corresponded with local left atrial activation. The second potential was shorter and narrower than the first. The sequence of activation in the second potential in the VOM was proximal to distal. In 6 patients with direct VOM recordings, we documented that the origin of AF was in the muscle bundle within the LOM. Radiofrequency catheter ablation aimed at the insertion site of the VOM successfully terminated AF in 4 of these 6 patients. Conclusions - (1) It is possible to cannulate and to record electrical potentials from the VOM. (2) The characteristics of the double potentials within the VOM suggest that the second potential is from the muscle bundle (Marshall bundle) within the LOM. (3) The Marshall bundle may be the origin of focal AF in some patients.",
keywords = "Arrhythmias, Catecholamines, Catheter ablation, Electrophysiology, Potentials",
author = "Chun Hwang and Wu, {Tsu Juey} and Doshi, {Rahul N.} and Peter, {C. Thomas} and Peng-Sheng Chen",
year = "2000",
month = "4",
day = "4",
language = "English (US)",
volume = "101",
pages = "1503--1505",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "13",

}

TY - JOUR

T1 - Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation

AU - Hwang, Chun

AU - Wu, Tsu Juey

AU - Doshi, Rahul N.

AU - Peter, C. Thomas

AU - Chen, Peng-Sheng

PY - 2000/4/4

Y1 - 2000/4/4

N2 - Background - Whether or not the muscle bundle within the ligament of Marshall (LOM) can serve as the origin of focal atrial fibrillation (AF) is unknown. Methods and Results - A total of 28 consecutive patients with paroxysmal AF underwent balloon-occlusion coronary sinus angiograms to identify the vein of Marshall (VOM). Attempts were then made to advance a 1.5-French electrophysiological catheter into the VOM via the coronary sinus orifice. In 17 of the 28 patients (10 of 17 were men aged 38±15 years), cannulation was successful. Double potentials were registered in 8 of these 17 patients. The first potential corresponded with local left atrial activation. The second potential was shorter and narrower than the first. The sequence of activation in the second potential in the VOM was proximal to distal. In 6 patients with direct VOM recordings, we documented that the origin of AF was in the muscle bundle within the LOM. Radiofrequency catheter ablation aimed at the insertion site of the VOM successfully terminated AF in 4 of these 6 patients. Conclusions - (1) It is possible to cannulate and to record electrical potentials from the VOM. (2) The characteristics of the double potentials within the VOM suggest that the second potential is from the muscle bundle (Marshall bundle) within the LOM. (3) The Marshall bundle may be the origin of focal AF in some patients.

AB - Background - Whether or not the muscle bundle within the ligament of Marshall (LOM) can serve as the origin of focal atrial fibrillation (AF) is unknown. Methods and Results - A total of 28 consecutive patients with paroxysmal AF underwent balloon-occlusion coronary sinus angiograms to identify the vein of Marshall (VOM). Attempts were then made to advance a 1.5-French electrophysiological catheter into the VOM via the coronary sinus orifice. In 17 of the 28 patients (10 of 17 were men aged 38±15 years), cannulation was successful. Double potentials were registered in 8 of these 17 patients. The first potential corresponded with local left atrial activation. The second potential was shorter and narrower than the first. The sequence of activation in the second potential in the VOM was proximal to distal. In 6 patients with direct VOM recordings, we documented that the origin of AF was in the muscle bundle within the LOM. Radiofrequency catheter ablation aimed at the insertion site of the VOM successfully terminated AF in 4 of these 6 patients. Conclusions - (1) It is possible to cannulate and to record electrical potentials from the VOM. (2) The characteristics of the double potentials within the VOM suggest that the second potential is from the muscle bundle (Marshall bundle) within the LOM. (3) The Marshall bundle may be the origin of focal AF in some patients.

KW - Arrhythmias

KW - Catecholamines

KW - Catheter ablation

KW - Electrophysiology

KW - Potentials

UR - http://www.scopus.com/inward/record.url?scp=0034603857&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034603857&partnerID=8YFLogxK

M3 - Article

VL - 101

SP - 1503

EP - 1505

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 13

ER -