{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:02:50Z","timestamp":1789390970358,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perimitral atrial flutter (PMF) involving the vein of Marshall (VOM) remains a therapeutic challenge. The role of pulsed field ablation (PFA) in the treatment of PMF is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 65\u2010year\u2010old male was admitted with a 7\u2010year history of palpitations. He had undergone three previous radiofrequency ablation procedures for atrial fibrillation and atrial flutter (AFL). He was readmitted due to recurrent AFL, with an electrocardiogram indicating atypical AFL. A three\u2010dimensional electrophysiological activation map of the left atrium revealed a macro\u2010reentrant circuit consistent with clockwise PMF. This was characterized by gaps in color isochrones and a total mapped activation time that was shorter than the tachycardia cycle length. The earliest activation was observed at the CS 5\u20136 electrodes, where a distinct double atrial potential was also recorded. These findings suggested an epicardial connection from the VOM to the circuit. PFA using the VARIPULSE PFA was successfully used to terminate the AFL at the VOM's endocardial insertion site into the left atrium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In our case, PFA appears to be a safe and effective strategy for targeting the endocardial insertion site of the VOM for VOM\u2010mediated PMF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70419","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:11:59Z","timestamp":1789387919000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulsed Field Ablation for Perimitral Atrial Flutter With Involvement of the Vein of Marshall: A Case Report"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1524-7551","authenticated-orcid":false,"given":"Chenghong","family":"Bao","sequence":"first","affiliation":[{"name":"Department of Cardiology National Center for Cardiovascular Diseases, FUWAI Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"},{"name":"Department of Cardiology Affiliated Jinhua Hospital, Zhejiang University School of Medicine  Jinhua China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4339-6194","authenticated-orcid":false,"given":"Lai Kuan","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Center for Cardiovascular Diseases, FUWAI Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"},{"name":"Department of Cardiology Sarawak Heart Centre  Kota Samarahan Sarawak Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanhao","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Center for Cardiovascular Diseases, FUWAI Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3335-9553","authenticated-orcid":false,"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Center for Cardiovascular Diseases, FUWAI Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianhua","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Cardiology Chengde Central Hospital Second Clinical College of Chengde Medical University  Chengde China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Affiliated Jinhua Hospital, Zhejiang University School of Medicine  Jinhua China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4003-4323","authenticated-orcid":false,"given":"Yan","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Center for Cardiovascular Diseases, FUWAI Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5180-4772","authenticated-orcid":false,"given":"Lingmin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Center for Cardiovascular Diseases, FUWAI Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.10.017"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.05.019"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14052"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2023.04.002"},{"issue":"2","key":"e_1_2_12_6_1","first-page":"258","article-title":"Elaborating Endocardial Mapping the Marshall Bundle Revealed a Perimitral Flutter Mediated by Ligament of Marshall","volume":"22","author":"Chen 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Medicine"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-022-01436-1"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-025-02079-8"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2025.06.036"},{"issue":"11","key":"e_1_2_12_18_1","first-page":"1932","article-title":"Ablation of Cavotricuspid Isthmus\u2010Dependent Atrial Flutter Using a Focal Monopolar Pulsed\u2010Field Ablation Catheter: Feasibility, Periprocedural Coronary Spasms and Conduction Disorders","volume":"22","author":"Farnir F.","year":"2025","journal-title":"Heart Rhythm"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16719"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrcr.2025.02.014"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.08.053"},{"key":"e_1_2_12_22_1","first-page":"S2405","article-title":"Effects of Pulsed Field Ablation for Pulmonary Vein Isolation on Vein of Marshall Electrograms JACC","volume":"12","author":"Nakatani Y.","year":"2026","journal-title":"Clinical Electrophysiology"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.122.011110"}],"container-title":["Pacing and Clinical 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