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Objective To explore the mechanisms of ligament of Marshall (LOM) initiat and sustain atrial fibrillation (AF).Methods The electrophysiologic properties of canine LOM were investigated using multipolar catheter mapping(normal canines,n =4,group A;AF canines,n =5,group B).The programmed stimulation were performed in the LOM,PV-left atrium(LA)junction and LA,respectively.Activations maps of LOM were analyzed from episodes of spontaneous onset of AF and initiation of induced AF by a single extrastimulus.The effectives refractory period of each part was compared and statistically analyzed among three parts in each group and between the two groups.LOM were cutted with surgical incision technology.The inducing rate of AF and the mapping rate of double potential and fragmented electrocardiogram were compared and statistically analyzed pro and post isolation of LOM.Results The incidence of abnormal potential of LOM in the two groups was significantly different(P ＜0.01),re-entry cycle(group A 25％ vs.B group 80％),tachycardia(group A 25％ vs.B 100％),double potential(group A 25％ vs.group B 80％),fragmentation potential(group A 25％ vs.group 80％).There was a significant difference in the rate of LOM tachycardia induction before and after LOM intervention in group B (P ＜ 0.05,before 100％ vs.after 20％).Conclusion There are two possible mechanisms of LOM involved in the occurrence and maintenance of AF:one is that LOM induces AF through spontaneous excitation,the other is that LOM participates in the reentry of left atrium and pulmonary vein in the form of bypass to induce and maintain AF.
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onclusions Both three-dimensional CT and MR images integrated into an CARTO system can be successfully used to perform catheter ablation for AF and there was no difference in registration accuracy between the two groups.
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0.05),as well as in the composite of MACCE(0.47% vs 1.14%) between the two groups.Also,no significant difference existed in the rate of target vessel revascularization(3.48% vs 3.28%,P=0.958),occlusion of lower extremity artery(0.67% vs 0.82%,P=0.857) and hemorrhagic events(0.67% vs 0.82%,P=0.613) between the two groups.Kaplan-Meier survival analysis showed the cumulative hazard rate for the MACCE was similar(P=0.521).There were 5 and 4 CR patients in the Plavix group and the clopidogrel bisulfate group,respectively.Dose enlargement in addition to dual antiplatelet therapy decreased significantly the PAR of CR patients in both groups(78.2%?11.9%,76.2%?10.5%,vs 80.8%?13.2%,81.8%?12.2%,P