Vein of Marshall partially isolated with radiofrequency ablation from the endocardium Shin Kashimura, MD, Takahiko Nishiyama, MD, Takehiro Kimura, MD,

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Presentation transcript:

Vein of Marshall partially isolated with radiofrequency ablation from the endocardium Shin Kashimura, MD, Takahiko Nishiyama, MD, Takehiro Kimura, MD, FHRS, Nobuhiro Nishiyama, MD, Yoshiyasu Aizawa, MD, FHRS, Seiji Takatsuki, MD, FHRS HeartRhythm Case Reports Volume 3, Issue 2, Pages 120-123 (February 2017) DOI: 10.1016/j.hrcr.2016.08.008 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 A: An ectopic activity from the distal or middle part of the vein of Marshall (VOM) was recorded during atrial fibrillation. The cycle length of coronary sinus (CS) and left atrial appendage (LAA) was longer than the VOM. CS and LAA were passively activated. B: Catheter position (RAO 30 degrees/LAO 55 degrees). A circumferential 20-pole catheter was located in the LAA. A 2 F catheter was inserted into the VOM. LAO = left anterior oblique; LLRA = lower lateral right atrium; RAO = right anterior oblique; RVA = right ventricular apex. HeartRhythm Case Reports 2017 3, 120-123DOI: (10.1016/j.hrcr.2016.08.008) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 A: Before ablation. An ectopic activity was recorded in the distal vein of Marshall (VOM). A fractionated electrogram was recorded in the middle of the VOM. B: Ablation near electrode VOM4 resulted in dissociation of the electrical activity from the distal and the proximal segments of the VOM. C: Ablation at VOM2–3 eliminated activation at VOM2–3/3–4. An ectopic activity from the distal VOM continued. D: Ablation at VOM1 eliminated all activation of distal VOM. HeartRhythm Case Reports 2017 3, 120-123DOI: (10.1016/j.hrcr.2016.08.008) Copyright © 2016 Heart Rhythm Society Terms and Conditions