Skip Navigation

European Heart Journal 2008 29(3):356-362; doi:10.1093/eurheartj/ehm606
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Cabrera, J. A.
Right arrow Articles by Sánchez-Quintana, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cabrera, J. A.
Right arrow Articles by Sánchez-Quintana, D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

The architecture of the left lateral atrial wall: a particular anatomic region with implications for ablation of atrial fibrillation

José Angel Cabrera1, Siew Yen Ho2,*, Vicente Climent3 and Damián Sánchez-Quintana3

1 Arrrythmias Unit, Department of Cardiology, Hospital-Quirón, Universidad Europea de Madrid, Spain
2 National Heart and Lung Institute, Imperial College London, and Royal Brompton and Harefield NHS Trust, Guy Scadding Building, Dovehouse Street, London SW3 6LY, UK
3 Departamento de Anatomía Humana, Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain

Received 31 July 2007; revised 12 November 2007; accepted 6 December 2007.

* Corresponding author. Tel: +44 20 7351 8752, Fax: +44 20 7351 8230. Email: yen.ho{at}imperial.ac.uk

Aims: We examined the left lateral ridge (LLR) between the orifices of the left pulmonary veins and the left atrial appendage for a better understanding of its structural composition relevant to ablations for atrial fibrillation (AF).

Methods and results: The LLR and its surrounding areas were studied in 40 heart specimens by dissection and histological sections. The LLR is a fold of the atrial wall with a mean width that was narrower superiorly than inferiorly (P < 0.001). Its myocardial thickness at the antero-superior level was thicker than at the postero-inferior level (2.8 ± 1.1 vs. 1.7 ± 0.8 mm, P < 0.001). Transmurally from subepicardium to subendocardium, the LLR comprises myofibres from the leftward extension of Bachmann's bundle together with the inferior branches of the septopulmonary bundle and the septoatrial bundle. The vein or ligament of Marshall is located on the epicardial aspect of the LLR. The Marshall structures and autonomic nervous system are in close proximity (<3 mm) to the endocardial surface at the superior level of the ridge in 70% of specimens.

Conclusion: The variability in width and thickness of the LLR, its proximity to Marshall structures and autonomic nerves, and myofibre arrangement may be significant in the fibrillatory process and spread of AF activity.

Key Words: Anatomy • Atrial fibrillation • Bachmann's bundle • Left atrium


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.