{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:04:53Z","timestamp":1754154293703,"version":"3.41.2"},"reference-count":6,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"Background<\/jats:title>Senile transthyretin cardiac amyloidosis (AL) is an underdiagnosed infiltrative cardiomyopathy causing heart failure symptoms in elderly patients. It is associated with a higher incidence of atrial fibrillation (AF) and atrial flutter.<\/jats:p><\/jats:sec>Case summary<\/jats:title>A 75-year-old male patient with senile transthyretin cardiac AL presented with congestive heart failure [New York Heart Association (NYHA) IV] related to rapid perimitral atrial flutter, causing tachycardia-induced cardiomyopathy with a left ventricular ejection fraction (LVEF) of 25%. He underwent AF voltage-guided ablation with vein of Marshall (VOM) ethanol infusion to block the mitral isthmus. Left atrial bipolar voltage mapping revealed diffuse and severe left atrial low-voltage areas related to amyloid protein infiltration within the left atrium (LA). After a 48-month follow-up, no arrhythmia recurrence was observed. Heart failure symptoms improved significantly (NYHA I\u2013II) with an improved LVEF of approximately 45%\u201350%.<\/jats:p><\/jats:sec>Discussion<\/jats:title>Diffuse and severe left atrial fibrosis related to amyloid protein infiltration within the LA is generally associated with worse catheter ablation outcomes in cardiac AL patients. This case demonstrated that the VOM ethanol infusion was critical to the success of the catheter ablation procedure, resulting in a better long-term outcome.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1589051","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T05:32:59Z","timestamp":1753335179000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of catheter ablation with vein of Marshall ethanol infusion for perimitral flutter in a patient with senile transthyretin cardiac amyloidosis: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Simon","family":"Fitouchi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mickael","family":"Ohana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Cardi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Jesel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halim","family":"Marzak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1161\/CIRCULATIONAHA.115.018852","article-title":"Heart failure resulting from age-related cardiac amyloid disease associated with wild-type transthyretin: a prospective, observational cohort study","volume":"133","author":"Connors","year":"2016","journal-title":"Circulation"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1016\/j.jacc.2016.06.033","article-title":"Natural history of wild-type transthyretin cardiac amyloidosis and risk stratification using a novel staging system","volume":"68","author":"Grogan","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"4305","DOI":"10.1002\/ehf2.12964","article-title":"Isolated atrial amyloidosis suspected by electrophysiological voltage mapping and diagnosed by 99\u2005m Tc-DPD scintigraphy","volume":"7","author":"Sch\u00f6ppenthau","year":"2020","journal-title":"ESC Heart Fail"},{"key":"B4","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1111\/pace.13992","article-title":"Catheter ablation of atrial fibrillation in cardiac amyloidosis","volume":"43","author":"Black-Maier","year":"2020","journal-title":"Pacing Clin Electrophysiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1111\/jce.13046","article-title":"Catheter ablation for atrial arrhythmias in patients with cardiac amyloidosis","volume":"27","author":"Tan","year":"2016","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.acvd.2024.10.323","article-title":"Management of conduction disease and arrhythmias in patients with cardiac amyloidosis: a position paper from the Working Group of Cardiac Pacing and Electrophysiology of the French Society of Cardiology","volume":"118","author":"Lellouche","year":"2025","journal-title":"Arch Cardiovasc Dis"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1589051\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T05:33:00Z","timestamp":1753335180000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1589051\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":6,"alternative-id":["10.3389\/fcvm.2025.1589051"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1589051","relation":{},"ISSN":["2297-055X"],"issn-type":[{"type":"electronic","value":"2297-055X"}],"subject":[],"published":{"date-parts":[[2025,7,24]]},"article-number":"1589051"}}