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High\u2010density mapping of these arrhythmias has demonstrated firstly that a patchy lesion set is highly proarrhythmogenic, favoring macro\u2010re\u2010entry through conduction slowing and providing pivots for localized re\u2010entry. Secondly, discrete anatomical structures such as the Vein or Ligament of Marshall (VOM\/LOM) and the coronary sinus (CS) have epicardial muscular bundles that are more frequently involved in re\u2010entry than previously thought. The Marshall Bundle can be ablated at any point along its course from the mid\u2010to\u2010distal coronary sinus to the left atrial appendage. If necessary, the VOM may be directly ablated using ethanol infusion to eliminate PV contributions and produce conduction block across the mistral isthmus. Ethanol ablation of the VOM, supplemented with RF ablation, may be more effective in producing conduction block at the mitral isthmus than repeat RF ablation alone.<\/jats:p>","DOI":"10.1111\/pace.14208","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T13:54:36Z","timestamp":1615298076000},"page":"782-791","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Ligament of Marshall ablation for persistent atrial fibrillation"],"prefix":"10.1111","volume":"44","author":[{"given":"Konstantinos","family":"Vlachos","sequence":"first","affiliation":[{"name":"LIRYC, University of Bordeaux, CHU de Bordeaux, Bordeaux France, Service de Rhythmologie H\u00f4pital Cardiologique du Haut\u2010L\u00e9v\u00eaque (Centre Hospitalier Universtaire de Bordeaux)  Talence Aquitaine 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