ArticleFrontiers in cardiovascular medicine2022
Optimization of intra-operative electrophysiological localization of the ligament of Marshall.
Article in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Peak-to-Peak Voltage Mapping Reveals Dynamic Arrhythmogenic Substrate Behavior in Isolated Rabbit Hearts.Annals of biomedical engineering · 2026Article
- Epicardial muscle bundles in persistent atrial fibrillation: from overlooked bystanders to arrhythmogenic modulators.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
- The Marshall Complex in the Human Heart: Embryology, Microanatomy, Autonomic Features and Clinical Implications for Atrial Fibrillation-A State-of-the-Art Narrative Review.Journal of clinical medicine · 2025Review
- The vestigial fold in humans: Characterization of a potential novel target for selective cardiac sympathetic denervation.Heart rhythm · 2025Article
- The Ligament of Marshall: Far From Vestigial!Annals of thoracic surgery short reports · 2025Article
- Research Advances of Non-Noble Metal Catalysts for Oxygen Evolution Reaction in Acid.Materials (Basel, Switzerland) · 2024Review
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Authors and funding
5 authors.
Funding
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Abstract
Background: The ligament of Marshall (LOM) may play a role in the pathophysiology of several tachyarrhythmias and accurate electrophysiological localization of this structure is crucial for effective ablation therapy. This study therefore quantifies electrophysiological properties of the LOM, and identifies which electrogram (EGM) recording (uni- or bipolar) and processing technologies [local activation time (LAT) and/or voltage mapping] are most suitable for accurate localization of the LOM. Methods: The LOM was electrophysiologically identified in 19 patients (mean age 66 ± 14 years; 12 male) undergoing elective cardiac surgery using intra-operative high-density epicardial mapping, to quantify and visualize EGM features during sinus rhythm. Results: Only a third of LOM potentials that were visualized using unipolar EGMs, were still visible in bipolar activation maps. Unipolar LOM potentials had lower voltages (P50: LOM: 1.51 (0.42-4.29) mV vs. left atrium (LA): 8.34 (1.50-17.91) mV, Conclusion: The LOM was most accurately localized in activation and voltage maps by using unipolar EGMs with annotation of primary deflections in case of single potentials and secondary deflections in case of double or fractionated potentials.
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