Document Detail

Differentiating the ligament of Marshall from the pulmonary vein musculature potentials in patients with paroxysmal atrial fibrillation: electrophysiological characteristics and results of radiofrequency ablation.
MedLine Citation:
PMID:  11060869     Owner:  NLM     Status:  MEDLINE    
It was reported that paroxysmal atrial fibrillation (PAF) can be initiated by ectopic atrial beats originating from the pulmonary vein (PV) or left atrial tract (LAT) within the ligament of Marshall (LOM). The aim of this study was to differentiate the LAT from the PV potentials, and to investigate the results of radiofrequency ablation guided by these potentials. Ten patients (age 60 +/- 12 years) with PAF who had a recording of double potentials (DPs) in or around the left PV were included. Group I had five patients with the second deflection of DPs (D2) due to activation of the LAT, and Group II had five patients with D2 due to activation of the PV musculature. There were no significant difference in the isoelectric interval between DPs, the activation time, and amplitude of D2 between Groups I and II. During distal coronary sinus (CS) pacing, the CS ostium (CSO) to D2 interval was shorter compared with that during sinus rhythm in Group I (39 +/- 19 vs 71 +/- 25 ms, P = 0.04), but was longer in Group II (96 +/- 16 vs 44 +/- 19 ms, P = 0.04). During ectopic activation, three patients in Group I, but no Group II patients, had transformation of recorded DPs into triple potentials. Radiofrequency ablation guided by the earliest activation of the LAT potential was performed with transient suppression of PAF, but ablation guided by the earliest activation of the PV potentials had a high success rate in eliminating PAF. In conclusion, differentiating the LAT from the PV potentials for initiation of PAF is feasible by an electrophysiological approach, and may be important for radiofrequency ablation of PAF.
C T Tai; M H Hsieh; C F Tsai; Y K Lin; W C Yu; S H Lee; Y A Ding; M S Chang; S A Chen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  23     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2001-01-31     Completed Date:  2001-03-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1493-501     Citation Subset:  IM    
Department of Medicine, National Yang-Ming University School of Medicine, Taipei Veterans General Hospital, Taiwan, R.O.C.
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MeSH Terms
Action Potentials / physiology
Atrial Fibrillation / physiopathology*,  surgery*
Catheter Ablation*
Electrophysiologic Techniques, Cardiac*
Follow-Up Studies
Heart Conduction System / physiopathology
Middle Aged
Pulmonary Veins*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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