The detrimental potential of arrhythmia‐induced cardiomyopathy

Eiringhaus, Jörg; Hamer, Okka W.; Hollemann, David; Brochhausen, Christoph; Vollmann, Dirk; Maier, Lars S.; Sossalla, Samuel

doi:10.1002/ehf2.12343

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…[5] The diagnosis of AIC was replaced by "idiopathic dilated cardiomyopathy" because of the absence of awareness about AIC. [6] Numerous theories presented the pathophysiology of AIC such as introducing cellular and molecular processes, cellular processes likely related to myocardial power consumption, cellular calcium metabolism changes, oxidative tension, ischemia, or apoptosis. [7] Cardiomyopathy is largely associated with long-term PVCs such as in our patient where there was a long-term presence of PVCs.…”

Section: Discussionmentioning

confidence: 99%

Arrhythmia-Induced Cardiomyopathy. A Palestinian Experience

Janem¹,

Zazo²,

Jobran³

2022

Al-Kindy Col. Med. J

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A 20 year-old male was admitted with a history of recurrent palpitations from 5 years. Baseline ECG revealed premature ventricular contractions (PVCs) with delta waves. Stress ECG showed short non-sustained Ventricular tachycardia (VT). Echocardiography showed moderate dilation of the left ventricle with mild reduced systolic function and Ejection fraction was estimated to be 42%. Right ventricle was mildly dilated and hypokinetic. Both atria were mildly dilated. The patient referred to CVC for EP study with possible ablation. The ablation of the focus led to complete suppression of the ectopy. Post-procedure ECG and echocardiography showed normalized rhythm and systolic function.

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Section: Discussionmentioning

confidence: 99%

Arrhythmia-Induced Cardiomyopathy. A Palestinian Experience

Janem¹,

Zazo²,

Jobran³

2022

Al-Kindy Col. Med. J

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“…Likewise, LVESVi and LVEDVi decreased 6 months post ablation in the CAMERA-MRI study, which evaluated the recurrence of AF after ablation compared to drug therapy [5]. The time course of LVEF recovery over several months suggests a prolonged "healing" from systolic heart failure, even if there is a quick initial LVEF improvement within the first weeks after ECV [20,21]. Baseline heart rates were 72/min (rate control group) and 103/min (inadequate rate control group) in Hsu et al [19] and 79/min in Prabhu et al [5].…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic Evaluation of LV Function in Patients with Tachyarrhythmia and Reduced Left Ventricular Function in Response to Rhythm Restoration

Schach

Körtl

Wachter

et al. 2021

JCM

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Aims: Tachyarrhythmia due to atrial fibrillation (AF) is often associated with reduced left ventricular (LV) function and has been proposed to cause arrhythmia-induced cardiomyopathy (AIC). However, the precise diagnostics of AIC and reversibility after rhythm restoration are poorly understood. Our aim was to investigate systolic LV function in tachycardic AF and to evaluate the direct effect of rhythm restoration. Methods: We prospectively studied 24 patients (71% male, age 65 ± 9 years) with tachycardic AF and newly diagnosed reduced left ventricular ejection fraction (LVEF). Just before and immediately after electrical cardioversion (ECV), transthoracic echocardiography was performed. Geometric as well as functional data were assessed. Results: Patients presented with a heart rate (HR) of 117.4 ± 21.6/min and a 2D-/3D-LVEF of 32 ± 9/31 ± 8%. ECV to sinus rhythm normalized HR to 77 ± 11/min with an increase of 2D-/3D-LVEF to 37 ± 9/37 ± 10% (p < 0.01 vs. baseline, each). Left ventricular geometry changed with an increase of end-diastolic volume (LVEDV) while end-systolic volume (LVESV) remained unchanged. Parameters concerning myocardial deformation (global longitudinal strain (GLS), strain rate (SR)) decreased whereas the RR interval-corrected GLS (GLSc) remained unchanged. In a simple linear regression model, GLS correlated with 2D- and 3D-LVEF not only before (pre) ECV, but also after (post) ECV. We demonstrate that the increase of LVEF and GLS (ratios pre/post) correlates with the change of HR (ΔHR; R2 = 0.20, 0.33 and 0.32, p < 0.05 each), whereas ratios of GLSc and SR do not significantly correlate with HR (R2 = 0.03 and 0.01, p = n.s. each). Conclusion: In patients with tachyarrhythmia and reduced ejection fraction, ECV leads to immediate improvement in EF and GLS while HR-corrected LV contractility remains unchanged. This suggests that the immediate effects of rhythm restoration are mostly related to changes in left ventricular volume, but not to an acute improvement of heart-rate independent contractility.

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