Use of fluoroscopic views for detecting Marshall's vein in patients with cardiac arrhythmias.
BACKGROUND
Recently, several studies showed that focal atrial fibrillation (AF) can be initiated by ectopic beats from the vein of Marshall (VOM). However, the incidence and best fluoroscopic views of VOM have never been reported.


RESULTS
106 patients (Non-AF = 52, AF = 54) underwent balloon-occluded coronary sinus angiography using seven fluoroscopic views (PA, Lateral, RAO 30 degrees, RA 30 degrees + Caudal 20 degrees, LAO 30 degrees, LAO 60 degrees, LAO 60 degrees + Cranial 20 degrees ). The total incidence of VOM was 74.5% (79/106), without significant difference in age (81.1 vs. 71.0%, >65 vs. <or=65 yrs, p = 0.257) and sex (male vs. female = 72.7 vs. 77.5%, p = 0.585). Furthermore, similar incidence of VOM was noted in patients with Non-AF (71.2%) and AF group (77.8%, p = 0.434). The RAO 30 degrees fluoroscopic view can demonstrate all the left atrial veins and VOM. However, only the LAO 30 degrees fluoroscopic view could confirm VOM and differentiate it from left atrial veins (after vs. before junction of coronary sinus and great cardiac vein, respectively).


CONCLUSIONS
VOM was equally distributed in patients with different arrhythmias, and the appropriate fluoroscopic view was important for the differential diagnosis of VOM and left atrial veins.
Tuan
Ta-Chuan
TC
Department of Medicine, National Yang-Ming University, School of Medicine and Taipei Veterans General Hospital, Taipei, Taiwan.
Tai
Ching-Tai
CT
Lin
Yung-Kuo
YK
Hsieh
Ming-Hsiung
MH
Tsai
Chin-Feng
CF
Ding
Yu-An
YA
Chen
Shih-Ann
SA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000503:physiopathology*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000033:anatomy & histology*; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005471:Fluoroscopy; D006325:Heart Atria / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000033:anatomy & histology; D013617:Tachycardia, Supraventricular / Q000503:physiopathology*; D014680:Veins / Q000033:anatomy & histology