From Ask Dr Wiki
Characteristics
- The Ligament of Marshall contains the nerve, vein, and muscle tracts which connect directly to the muscle sleeves of the coronary sinus.
- Can form a substrate that may be a source of paroxysmal atrial fibrillation which more frequently arises from the distal portion of the ligament.
- Ectopic atrial tachycardia arises more often form the proximal portion of the ligament
- P wave morphology is isoelectric in leads I and AVL, positive in leads II, III, aVF, and V2-V5.
Ablation
- Can be performed in the inferior region of the left atrum, just under the left pulmonary vein ostium
- Also can be used as a reference when performing a lateral isthmus line
References
- How and when to ablate the ligament of Marshall. Hwang, Chun; Fishbein, Michael C.; Chen, Peng-Sheng pp. 1505-1507. Heart Rhythm Journal December 2006.
