{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T06:48:04Z","timestamp":1782024484843,"version":"3.54.5"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial arrhythmias are a frequent and clinically significant complication in left ventricular assist device (LVAD)\u2013supported patients, with the potential to impair right ventricular (RV) function, compromise device hemodynamics, and reduce quality of life. While atrial fibrillation (AF) has received considerable attention in this population, the distinct hemodynamic impact of typical cavotricuspid isthmus (CTI)\u2013dependent atrial flutter and the role of catheter-based rhythm control remain poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 60-year-old male with non-ischemic cardiomyopathy who underwent HeartMate 3 LVAD implantation as a bridge to transplantation developed typical CTI-dependent atrial flutter refractory to medical therapy, associated with marked deterioration in RV systolic function (TAPSE: 1.2 \u2192 0.82\u00a0cm; Sm: 6.9 \u2192 5.3\u00a0cm\/s) and adverse LVAD hemodynamics. Electrical cardioversion had been attempted but failed to maintain sinus rhythm. Electrophysiological study using three-dimensional electroanatomic mapping (CARTO system, Biosense Webster) confirmed counterclockwise CTI-dependent atrial flutter. Radiofrequency (RF) ablation of the cavotricuspid isthmus achieved bidirectional conduction block and restored sinus rhythm. The procedure was performed under uninterrupted therapeutic anticoagulation with warfarin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At one-month follow-up, RV systolic function improved substantially (TAPSE: 0.82 \u2192 1.19\u00a0cm; Sm: 5.3 \u2192 6.5\u00a0cm\/s), with concurrent normalization of LVAD hemodynamic parameters and complete resolution of palpitations and dyspnea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Catheter ablation of CTI-dependent atrial flutter in a carefully selected LVAD-supported patient yielded significant improvement in RV function, device hemodynamics, and quality of life (QoL), underscoring the potential role of rhythm control in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s43044-026-00760-5","type":"journal-article","created":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T06:33:25Z","timestamp":1782023605000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Catheter ablation of typical atrial flutter in a patient with left ventricular assist device support: a case report"],"prefix":"10.1186","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8935-3308","authenticated-orcid":false,"given":"Azmican","family":"Kaya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7323-8843","authenticated-orcid":false,"given":"Murat","family":"Kara\u00e7am","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5384-1069","authenticated-orcid":false,"given":"Tezel","family":"Kovanc\u0131","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0933-9233","authenticated-orcid":false,"given":"Seda","family":"Tanyeri Uzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3022-2734","authenticated-orcid":false,"given":"Abd\u00fclkadir","family":"Uslu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,21]]},"reference":[{"issue":"36","key":"760_CR1","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","volume":"42","author":"TA McDonagh","year":"2021","unstructured":"McDonagh TA, Metra M, Adamo M et al (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. 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Written informed consent was obtained from the patient for participation in this case report and for the publication of all associated clinical data, imaging, and figures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"48"}}