[The vein of Marshall as a source of various types of atrial arrhythmias, including adrenergic paroxysmal atrial fibrillation--successful catheter ablation].
We describe a case of a 44-year old man with recurrent atrial arrhythmias (atrial ectopy, atrial tachycardia and fibrillation) originating from the vein of Marshall (VoM). Stress, exertion and isoproterenol increased frequency and duration of highly symptomatic arrhythmia paroxysms. In 2002 he underwent two sessions of RF ablation. In the area of the left inferior pulmonary vein ostium (LIPV) and along the course the VoM, spiky, firing potentials were recorded. Ablation of the VoM region induced high frequency focal firing (CL approximately 200 ms) with 1: 1 VoM-->LA conduction. Before sinus rhythm return, a gradual increase of conduction of VoM-->LA block was observed. During the second session residual breakthroughs were recorded. During 5 years of follow-up the patient remained free from arrhythmia without antiarrhythmic drugs.
Walczak
Franciszek
F
Instytut Kardiologii, ul. Alpejska 42, 04-628 Warszawa. fwalczak@ikard.pl
Bodalski
Robert
R
Szumowski
Lukasz
L
Zakrzewska
Joanna
J
Derejko
Paweł
P
Szufladowicz
Ewa
E
Orczykowski
Michał
M
Szaroszyk
Włodzimierz
W
Szymański
Piotr
P
Baranowski
Rafał
R
Kepski
Roman
R
D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000628:therapy*; D017115:Catheter Ablation; D004562:Electrocardiography; D006329:Heart Conduction System; D006801:Humans; D008297:Male; D011667:Pulmonary Veins / Q000503:physiopathology; D013614:Tachycardia, Paroxysmal / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome