ACC Council Addresses Management of Arrhythmia-Induced Cardiomyopathies

Early recognition of arrhythmia-induced cardiomyopathies results in symptom resolution for patients, according to a Council Perspective from the ACC’s Electrophysiology Council published Oct. 5 in the Journal of the American College of Cardiology.

According to the Council, the presence of pathological tachycardia or persistent arrhythmia during an unexplained cardiomyopathy indicates arrhythmia-induced cardiomyopathy in the patient. Further, health care professionals should consider patient history, physical examination results and clinical investigations when diagnosing the condition as certain characteristics make indicate a greater likelihood of arrhythmia-induced cardiomyopathy. Specifically, patients with the condition will have a smaller left ventricular end-diastolic diameter and mass index, as recognized with the use of cardiac magnetic resonance imaging.

The Council notes that in managing patients with arrhythmia-induced cardiomyopathy, clinicians should focus on eliminating the arrhythmia with catheter ablation and “attempt careful and aggressive control of rate and rhythm.” Long-term survival of the patient is likely following the resolution of the arrhythmia, with a low risk of sudden death.

“Future research should focus on specific pathophysiological mechanisms for cardiomyopathy in relation to a particular arrhythmia,” the Council states. “Novel approaches for early detection [of arrhythmia-induced cardiomyopathy], as well as targeted intervention, are warranted and may ultimately improve long-term outcomes for these patients.”

Download the audio commentary by JACC Editor-in-Chief Valentin Fuster, MD, PhD, MACC.

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Magnetic Resonance Imaging

Keywords: Arrhythmias, Cardiac, Cardiomyopathies, Catheter Ablation, Death, Sudden, Electrophysiology, Magnetic Resonance Imaging, Physical Examination, Tachycardia

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