Peri-Mitral Atrial Tachycardia Using the Marshall Bundle Epicardial Connections

Hayashi, Takekuni; Fukamizu, Seiji; Mitsuhashi, Takeshi; Kitamura, Τakeshi; Aoyama, Yuya; Hojo, Rintaro; Sugawara, Yoshitaka; Sakurada, Harumizu; Hiraoka, Masayasu; Fujita, Hideo; Momomura, Shin‐ichi

doi:10.1016/j.jacep.2015.08.011

Cited by 49 publications

(53 citation statements)

References 14 publications

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“…MAFL is commonly encountered after atrial fibrillation ablation and terminated by creating linear lesion sets across the MI, although epicardial structures like the vein of Marshall and coronary sinus may serve as a barrier for MI ablation transmurality. 2,4,5 While an anterior line is predominantly performed targeting thinner atrial myocardium, the thickness of epicardial structures in the region of BB is a barrier to achieving completely transmural lesions.…”

Section: Discussionmentioning

confidence: 99%

Epicardial recordings of Bachmann bundle activation during refractory mitral flutter with endocardial block

Nazari²,

Buck³

et al. 2020

HeartRhythm Case Reports

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Section: Discussionmentioning

confidence: 99%

Epicardial recordings of Bachmann bundle activation during refractory mitral flutter with endocardial block

Nazari²,

Buck³

et al. 2020

HeartRhythm Case Reports

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“…The vein or ligament of Marshall, is an anatomical structure related to atrial tachyarrhythmia . The Marshall bundle is reported to be involved with complex atrial tachycardia (AT) by bridging endocardial activation . Ethanol infusion is one strategy to treat Marshall bundle‐related atrial tachycardia (MB‐AT) .…”

Section: Introductionmentioning

confidence: 99%

Ethanol infusion for Marshall bundle epicardial connections in Marshall bundle‐related atrial tachycardias following atrial fibrillation ablation: The accessibility and success rate of ethanol infusion by using a femoral approach

Kitamura

Vlachos

Denis

et al. 2019

Cardiovasc electrophysiol

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Background Ethanol infusion of the vein of Marshall (VOM) may be effective to treat Marshall bundle‐related atrial tachycardia (MB‐AT). However, methods and clinical results of ethanol infusion for MB‐AT have been not established. Objective To assess the accessibility of the VOM and the success rate of ethanol infusion using a femoral approach for MB‐AT. Methods A single‐center observational study included consecutive patients who had MB‐AT and in whom we attempted to treat MB‐AT during AT by ethanol infusion. When the VOM was able to be cannulated following VOM venogram using a femoral approach, we systematically performed ethanol infusion with selective balloon occlusion of the VOM. We analyzed in detail the efficacy of ethanol infusion of VOM in patients who were in MB‐AT during ethanol infusion. Results We enrolled 54 consecutive patients in whom we attempted to treat MB‐AT by ethanol infusion. Of those, the VOM was accessible in 92.5% of patients (50 of 54). Of the 50 patients treated by ethanol infusion during MB‐AT, AT was successfully terminated in 56% percent of the patients (28 of 50) by solo treatment of ethanol infusion without RF ablation. The remainder required additional RF application to terminate the MB‐AT. A mean of 6.2 ± 2.8 mL of ethanol was infused resulting in the low‐voltage area significantly larger than that before ethanol infusion (12.7 ± 8.3 vs 6.6 ± 5.3 cm2, P < .001). Conclusion The present study demonstrated that the VOM was highly accessible and MB‐AT was amenable to treatment by ethanol infusion by using a femoral approach.

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“…Perimitral AT with an epicardial connection involving the VOM has been reported. 1 The role of the VOM was demonstrated during pacing 2 ; however, no activation map during tachycardia previously has been reported. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.…”

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confidence: 92%

High-density activation mapping during perimitral atrial tachycardia demonstrates epicardial connection through the vein of Marshall

et al. 2018

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Peri-Mitral Atrial Tachycardia Using the Marshall Bundle Epicardial Connections

Abstract: PMAT-LOMs following PVI or valve surgery accounted for up to 11% of PMATs. The bidirectional block of either MB-LA or CS-MB connections is required to eliminate PMAT-LOMs.

Cited by 49 publications

References 14 publications

Epicardial recordings of Bachmann bundle activation during refractory mitral flutter with endocardial block

Epicardial recordings of Bachmann bundle activation during refractory mitral flutter with endocardial block

Ethanol infusion for Marshall bundle epicardial connections in Marshall bundle‐related atrial tachycardias following atrial fibrillation ablation: The accessibility and success rate of ethanol infusion by using a femoral approach

High-density activation mapping during perimitral atrial tachycardia demonstrates epicardial connection through the vein of Marshall

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