Cardiac Codex

Vein of Marshall (Ligament of Marshall)

A EP Anatomy & the Conduction System term on the RCES exam blueprint, defined for cath lab and EP clinicians.

An embryological remnant of the left superior cardinal vein running along the posterior left atrial wall between the left superior pulmonary vein and left atrial appendage; contains the Marshall bundle, which forms epicardial bypass connections that can maintain mitral isthmus conduction despite a seemingly complete endocardial ablation line, requiring ethanol infusion for definitive epicardial chemical ablation.

Domain: EP Anatomy & the Conduction System · Blueprint: RCES exam guide

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