Work

Successful ablation of Marshall Bundle–related perimitral atrial flutter using pulsed field ablation

Year: 2026

Type: article

Abstract: Perimitral atrial flutter (AFL) is one of the most challenging arrhythmias due to the complex anatomical characteristics of mitral isthmus and associated epicardial structures.1 Epicardial conduction through the Marshall bundle across the mitral isthmus remains a major barrier in achieving complete lesion and bidirectional block. Successful interruption of the perimitral circuit requires precise understanding of the anatomical relationship at the Marshall bundle insertion site. Pulsed-field ablation (PFA) has been established as a rapid, safe, and effective modality for pulmonary vein (PV) isolation with durable outcomes,2 and has emerged as a potential strategy following failed radiofrequency (RF) ablation for mitral isthmus block.

Source: HeartRhythm Case Reports

DOI: 10.1016/j.hrcr.2026.07.027

Authors: Yae Min Park, Michael N. Jiang, Shumpei Mori, Justin H. Hayase

Institutions: University of California, Los Angeles, Ronald Reagan UCLA Medical Center, Gachon University Gil Medical Center

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,100