Korean Circ J.  2019 Sep;49(9):808-817. 10.4070/kcj.2019.0199.

Tachycardia induced Cardiomyopathy

• Kim DY
• Kim SH
• Ryu KH

• KMID: 2455786
• DOI: http://doi.org/10.4070/kcj.2019.0199

Abstract

Recent studies on radiofrequency catheter ablation (RFCA) in atrial fibrillation show its effectiveness in heart failure (HF) patients; hence, tachycardia-induced cardiomyopathy (T-CMP) is gaining attention. Tachycardia-mediated cardiomyopathy is a reversible left ventricular (LV) dysfunction, which can be induced by any tachyarrhythmia. Early recognition of T-CMP with appropriate treatment of the arrhythmia culprit will lead to the recovery of LV function. Patients with tachycardia and LV dysfunction should be suspected of having T-CMP, with or without established etiology of HF, because T-CMP may present by itself or contribute as a co-existent component. Therapeutic options include rate control, anti-arrhythmic drugs, or catheter ablation. Unlike in animal models, clinical data on human T-CMP is limited. Hence, future research should be more focused on tachyarrhythmia-induced cardiomyopathy as its burden is increasing.

Keyword

Heart failure; Tachycardia; Cardiomyopathies

MeSH Terms

Arrhythmias, Cardiac
Atrial Fibrillation
Cardiomyopathies*
Catheter Ablation
Heart Failure
Humans
Models, Animal
Tachycardia*

Figure

• 

  Figure 1 (A) Changes in cellular level in T-CMP. (B and C) Echocardiographic and gross change in pacing induced HF animal model. (A) Following sustained tachycardia, intracellular and extracellular remodeling leads to LV remodeling and worsening contractility. Decrease in L-type Ca2+ channel causes abnormal excitation-contraction coupling. Myocardial fibrosis persists even after recovery of LV function. (B) Echography in animal with pacing-induced HF (from Ryu et al.,29) Ross et al.38)). (C) Gross change in pacing-induced heart failure in animal (from Ryu et al.,29) Ross et al.38)): (a) normal rabbit before pacing, (b) low cardiac output status of rabbit after pacing with skin color change on ear and decreased activity, and (c) pacing induced HF rabbit showing edematous change and lethargic activity. HF = heart failure; LV = left ventricular; T-CMP = tachycardia-induced cardiomyopathy.

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