Chin Jung Yeon, Kim Jong Woo, Kang Ki-Woon
Division of Cardiology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea.
J Arrhythm. 2017 Aug;33(4):324-327. doi: 10.1016/j.joa.2016.11.002. Epub 2017 Jan 2.
Atrial fibrillation (AF) from the ligament/vein of Marshall (LOM/VOM) has previously been described. We report the case of a 23-year-old woman with an antiarrhythmic drug-resistant AF induced by two distinct atrial tachycardias (ATs). Focal ablation of these ATs from the double-exit of the Marshall bundle using a three-dimensional map eliminated AF triggering, even though pulmonary vein electrical isolation is the cornerstone for paroxysmal AF. Such mechanisms are important as triggering factors to plan ablation for paroxysmal AF. Focal ablation for triggering and inducing AF, originating from the double-exit of the Marshall bundle may be effective in eliminating AF in young patients.
先前已有关于起源于Marshall韧带/静脉（LOM/VOM）的心房颤动（AF）的描述。我们报告了一例23岁女性患者，其抗心律失常药物难治性AF由两种不同的房性心动过速（ATs）诱发。使用三维标测从Marshall束双出口对这些ATs进行局灶性消融消除了AF触发，尽管肺静脉电隔离是阵发性AF的基石。此类机制作为阵发性AF消融计划的触发因素很重要。起源于Marshall束双出口的触发和诱发AF的局灶性消融可能对消除年轻患者的AF有效。
