Sossalla, Samuel and Vollmann, Dirk (2018) Arrhythmia-Induced Cardiomyopathy. DEUTSCHES ARZTEBLATT INTERNATIONAL, 115 (19). pp. 335-341. ISSN 1866-0452
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Background: Heart failure affects 1-2% of the population and is associated with elevated morbidity and mortality. Cardiac arrhythmias are often a result of heart failure, but they can cause left-ventricular systolic dysfunction (LVSD) as an arrhythmia-induced cardiomyopathy (AIC). This causal relationship should be borne in mind by the physician treating a patient with systolic heart failure in association with cardiac arrhythmia. Methods: This review is based on pertinent publications retrieved by a selective search in PubMed (1987-2017) and on the recommendations in current guidelines. Results: The key criterion for the diagnosis of an AIC is the demonstration of a persistent arrhythmia (including pathological tachycardia) together with an LVSD whose origin cannot be explained on any other basis. Nearly any type of tachyarrhythmia or frequent ventricular extrasystoles can lead, if persistent, to a progressively severe LVSD. The underlying pathophysiologic mechanisms are incompletely understood; the increased ventricular rate, asynchronous cardiac contractions, and neurohumoral activation all seem to play a role. The most common precipitating factors are supraventricular tachycardias in children and atrial fibrillation in adults. Recent studies have shown that the causal significance of atrial fibrillation in otherwise unexplained LVSD is underappreciated. The treatment of AIC consists primarily of the treatment of the underlying arrhythmia, generally with drugs such as beta-blockers and amiodarone. Depending on the type of arrhythmia, catheter ablation for long-term treatment should also be considered where appropriate. The diagnosis of AIC is considered to be well established when the LVSD normalizes or improves within a few weeks or months of the start of targeted treatment of the arrhythmia. Conclusion: An AIC is potentially reversible. The timely recognition of this condition and the appropriate treatment of the underlying arrhythmia can substantially improve patient outcomes.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TACHYCARDIA-INDUCED CARDIOMYOPATHY; PREMATURE VENTRICULAR COMPLEXES; CONGESTIVE-HEART-FAILURE; CHRONIC ATRIAL-FIBRILLATION; 2015 ESC GUIDELINES; CATHETER ABLATION; RADIOFREQUENCY ABLATION; SYSTOLIC DYSFUNCTION; TIME-COURSE; SUPRAVENTRICULAR TACHYCARDIA; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Petra Gürster |
| Date Deposited: | 30 Jun 2020 12:50 |
| Last Modified: | 30 Jun 2020 12:50 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14581 |
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