Tachycardiomyopathy: a diagnosis not to be missed

Walker, Nicola L.; Cobbe, S M; Birnie, David H.

doi:10.1136/hrt.2003.017129

Cited by 25 publications

(7 citation statements)

References 7 publications

(7 reference statements)

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“…La taquicardiomiopatía puede ser inducida por arritmias supraventriculares y ventriculares. Puede ser difícil defi nir la relación causa efecto cuando la miocardiopatía y la taquicardia son encontradas simultáneamente [1][2][3][4][5][6][7] . La taquicardiomiopatía se puede clasifi car en dos categorías: "puras" cuando la taquicardia crónica se instala en un corazón normal y es el único agente responsable de la disfunción del VI.…”

Section: Discussionunclassified

Taquicardiomiopatía, causa reversible de insuficiencia cardiaca: caso clínico

et al. 2012

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Section: Discussionunclassified

Taquicardiomiopatía, causa reversible de insuficiencia cardiaca: caso clínico

et al. 2012

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“…18 Mechanisms of clozapine-induced cardiac toxicity are not fully understood. 22,23 Clozapine treatment is associated with an inappropriate sinus tachycardia at rest, and treatment with beta adrenergic blockers has been demonstrated to significantly improve LV function. 19,20 Clozapine induce blockade of human EtheRa-Go-go gene potassium channels, and iKr current may significantly contribute to QT prolongation in clozapine-treated patients.…”

Section: Discussionmentioning

confidence: 99%

Erratum

2011

Journal of Clinical Psychopharmacology

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Background: Available information regarding clozapine-related cardiomyopathy is limited to reports of severe left ventricular dysfunction not rarely with fatal clinical evolution. A subclinical cardiotoxic effect might be diagnosed using echocardiography and N-terminal pro-B-type natriuretic peptide assay.Methods: Thirty-eight patients with psychotic disorder in chronic therapy with clozapine (24 male and 14 female subjects; mean age, 38.4 years) were enrolled. Left ventricular ejection fraction (LVEF) was measured by area-length method (average of 5 measurements).Results: Twelve patients showed a mild depression of left ventricular function (LVEF between 50% and 55%), 2 LVEF less than 50% and 1 less than 30%. The area under the receiver operating characteristic curve for N-terminal pro-B-type natriuretic peptide as a predictor of left ventricular dysfunction was 0.87. Conclusions: A subclinical left ventricular dysfunction was found in3 of 38 patients, whereas a mild impairment of the left ventricular systolic function occurred in 1 of 3 of young, previously healthy, clozapinetreated patients A prospective study in clozapine-naive patients may be useful to better understand cardiotoxic effects of clozapine.

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“…The relation between chronic tachycardia and reversible ventricular dysfunction was first described in 1949 by Phillips and Levine in patients with atrial fibrillation and heart failure. However, the dilemma “what comes first” still remains, is the ventricular dysfunction a cause or a consequence of the arrhythmia= Tachycardiomyopathy is defined as reversible myocardial dysfunction secondary to chronic ventricular or supraventricular tachycardia [1]. Reversal of the arrhythmia results in improvements in symptoms, exercise capacity, and partial or total recovery of the ventricular function, which occurs over a variable period of time.…”

Section: Discussionmentioning

confidence: 99%

Recovery of systolic and diastolic function after ablation of incessant supraventricular tachycardia

Salemi

Arteaga

Mady

2005

European J of Heart Fail

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We report a case of a 26-year-old woman who presented to our hospital with arrhythmia and heart failure. She had an incessant supraventricular tachycardia, which was not reversible with electrical cardioversion. Echocardiogram showed a severe LV systolic and diastolic dysfunction. After radiofrequency catheter ablation, LV function returned to normal. This article is intended to show a case with tachycardiomyopathy, which is considered the most frequently unrecognized curable cause of heart failure, and to demonstrate that early treatment allows the recovery to a normal LV systolic and diastolic function, preventing irreversible structural cardiac damage. It is very likely that some patients with idiopathic dilated cardiomyopathy and chronic atrial fibrillation or other chronic arrhythmia actually have a curable tachycardiomyopathy. Case ReportA 26-year-old mulatto female patient was admitted to the Heart Institute (InCor) with dilated cardiomyopathy, which had been diagnosed 14 months before admission. During that period, she was receiving lisinopril 10 mg/day and digoxin 0.25 mg/day. Two weeks prior to admission, her condition had become worse. At admission, she was in New York Heart Association functional class II with atypical chest pain, palpitations and dyspnoea of effort.On examination she presented good general condition, blood pressure 100Â60 mmHg and heart rate 126 bpm. The cardiac impulse was diffuse and displaced inferior and laterally. The cardiac rhythm was regular, with S 3 gallop, increased P 2 and mild holosystolic murmur in the mitral and tricuspid area. The rest of her physical exam was normal. Her thyroid hormones and ferritin were within the normal range, and Chagas' disease serology was negative. The electrocardiographic (ECG) characteristics of the tachycardia did not allow differentiation between atrial, sinoatrial or AV type Coumel (Fig. 1). A 24-h Holter monitoring showed sinus rhythm alternated with incessant supraventricular tachycardia. The mean heart rate was 119 bpm (44-166 bpm), and the incessant supraventricular tachycardia was present for more than two thirds of the 24-h period.Standard transthoracic echocardiogram showed a dilated and severe globally hypokinetic left ventricle (LV, Fig. 2), left atrium of 47 mm, mild mitral and tricuspid regurgitations, and a restrictive left ventricular filling pattern. Electrical cardioversion was performed without success. The patient underwent electrophysiological testing, and was submitted to successful transcatheter radiofrequency ablation of accessory pathway located in the right posterio-septal zone. The patient has remained well and in sinus rhythm for the last 88 months following resolution of the tachycardia. The echocardiogram performed 6 months after the procedure showed an improvement in LV ejection fraction (Fig. 2) and, when repeated 88 months later, showed a totally normal systolic and diastolic function. Normal diastolic function was confirmed by pulsed-wave tissue Doppler 1388-9842/$ -see front matter D

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Tachycardiomyopathy: a diagnosis not to be missed

Cited by 25 publications

References 7 publications

Taquicardiomiopatía, causa reversible de insuficiencia cardiaca: caso clínico

Taquicardiomiopatía, causa reversible de insuficiencia cardiaca: caso clínico

Erratum

Recovery of systolic and diastolic function after ablation of incessant supraventricular tachycardia

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