Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation
Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation
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DOI：
10.1161/01.cir.101.13.1503
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发表时间：
2000-04-04
期刊：
影响因子：
37.8
通讯作者：
Chen, PS
中科院分区：
文献类型：
--
作者：
Hwang, C;Wu, TJ;Chen, PS
背景-马歇尔韧带(LOM)内的肌束是否可以作为局灶性心房颤动(AF)的起源尚不清楚。方法和结果-连续28例阵发性房颤患者接受了球囊闭塞冠状静脉窦造影以识别马歇尔静脉(VOM)。然后试图通过冠状静脉窦口将一根1.5法式的电生理导管推进到动静脉畸形中。在28例患者中，有17例(其中10例为男性，年龄38+/-15岁)插管成功，其中8例出现双电位。第一个电位与左房局部激活相对应。第二种电势比第一种电势更短、更窄。动静脉络膜第二电位的激活顺序为近端至远端。在6例直接记录VOM的患者中，我们记录到房颤起源于LOM内的肌束，针对VOM附着点的射频导管消融成功终止了这6例患者中的4例。(2)VOM内双电位的特征提示第二电位来自LOM内的肌束(马歇尔束)；(3)马歇尔束可能是部分患者局灶性房颤的起始点。
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.