Dronedarone - or ablation of the ligament of Marshall

[Spin-off]

Thank you everyone for replying to my question - and so quickly. This forum really is fabulous. I have a few weeks to decide what to do next - Dronedarone or ablation of the ligament of Marshall. I need to find out more about that ablation but haven’t really started yet. I’m in NSR - infact I’m really lucky that I’m usually mostly in NSR. It’s just that when my AF starts it won’t stop and I’m very symptomatic. And as I can’t stay on amiodarone and can’t take Flecanide I have to do something. Let’s see.

[MarkS]

My ligament of Marshall was ablated after my PV's had been ablated using a combined cryo/RF (But during the same ablation). The ligament of Marshall is a frequent source of errant beats, particularly in longer standing AF. I was about 80% in AF at the time of my ablation and on the verge of going persistent. Fortunately my EP (Prof Schilling) was very experienced and identified further errant beats from the ligament.

Dronedarone does not seem that effective. I would check your EP is experienced in ablation of the ligament. It can only be done with RF, so your EP needs to be expert in that and isn't just a cryo man. The ablation of the LoM made the difference for me, I've been pretty much AF free in the 12 years since the single ablation.

Best wishes, Mark

[Spin-off in reply to MarkS]

Wow. Symptom free for 12 years - that sounds fabulous. I’ll do all the necessary checking before I consent to anything. First I want to talk to my UK cardiologist to take his view. I’m certainly starting to feel more inclined to go ahead with the LoM than dronedarone. Surely taking another super toxic drug should only happen if I’m unlucky and the LoM doesn’t work for long. The main thing that put me off the procedure in the first place was the memory of my horrible experience with punctured pericardium in 2020 - but lightning very rarely strikes twice does it?