Arrhythmia-induced Cardiomyopathy: An Article Review

Sidhi Laksono Purwowiyoto; Hillary Kusharsamita

doi:10.3889/oamjms.2022.8133

Authors

Sidhi Laksono Purwowiyoto Department of Cardiology and Vascular Medicine, RS Pusat Pertamina, South Jakarta, Indonesia; Faculty of Medicine, Universitas Muhammadiyah Prof. DR. Hamka, Tangerang, Indonesia
Hillary Kusharsamita Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8133

Keywords:

Arrhythmia, Cardiomyopathy, Tachycardia, Premature ventricular complexes, Atrial fibrillation, Ventricular dysfunction, Heart failure

Abstract

Arrhythmia is one of the significant reversible causes in patients with heart disease and left ventricular dysfunction. Tachycardia, atrial fibrillation, and premature ventricular contractions have indeed been related to arrhythmia-induced cardiomyopathy (CM), a reversible dilated CM. Effective arrhythmia suppression will entirely or partially recover ventricular function, lowering morbidity and mortality. However, the importance of arrhythmia-induced CM (ARiCM) is often underestimated in clinical practice because arrhythmia is often seen as a result rather than a cause of CM, leading in treatment delays and failure to increase the quality of life and better clinical outcomes. This article review aims to summarize the pathomechanisms, and a general approach to the management of ARiCM and its long-term outcomes. ARiCM can cause a variety of clinical signs, ranging from asymptomatic to severe heart failure symptoms. Electrocardiogram, 24 h Holter monitoring, echocardiography, and cardiac magnetic resonance are all recommended for diagnosis. More research is required to better understand the pathogenesis of ARiCM and to differentiate treatment alternatives to choose the ideal ARiCM management approach.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Jain A, Selvaraj RJ. Arrhythmia-induced cardiomyopathy. Indian J Clin Cardiol. 2021;11:201-4. https://doi.org/10.1177/2632463620987975 DOI: https://doi.org/10.1177/2632463620987975

Sossalla S, Vollmann D. Arrhythmia-induced cardiomyopathy. Dtsch Arztebl Int. 2018;115(19):335-41. https://doi.org/10.3238/arztebl.2018.0335 PMid:29875055 DOI: https://doi.org/10.3238/arztebl.2018.0335

Ju W, Yang B, Li M, Zhang F, Chen H, Gu K, et al. Tachycardiomyopathy complicated by focal atrial tachycardia: incidence, risk factors, and long-term outcome. J Cardiovasc Electrophysiol. 2014;25(9):953-957. https://doi.org/10.1111/jce.12428 PMid:24716793 DOI: https://doi.org/10.1111/jce.12428

Kang KT, Etheridge SP, Kantoch MJ, Tisma-Dupanovic S, Bradley DJ, Balaji S, et al. Current management of focal atrial tachycardia in children: A multicenter experience. Circ Arrhythm Electrophysiol. 2014;7(4):664-70. https://doi.org/10.1161/CIRCEP.113.001423 PMid:25015944 DOI: https://doi.org/10.1161/CIRCEP.113.001423

Brembilla-Perrot B, Ferreira JP, Manenti V, Sellal JM, Olivier A, Villemin T, et al. Predictors and prognostic significance of tachycardiomyopathy: Insights from a cohort of 1269 patients undergoing atrial flutter ablation. Eur J Heart Fail. 2016;18(4):394-401. https://doi.org/10.1002/ejhf.482 PMid:26833591 DOI: https://doi.org/10.1002/ejhf.482

Marrouche NF, Brachmann J, Andresen D, Siebels J, Boersma L, Jordaens L, et al. Catheter ablation for atrial fibrillation with heart failure. N Engl J Med. 2018;378(5):417-27. https://doi.org/10.1056/NEJMoa1707855 PMid:29385358 DOI: https://doi.org/10.1056/NEJMoa1707855

Bogun F, Crawford T, Reich S, Koelling TM, Armstrong W, Good E, et al. Radiofrequency ablation of frequent, idiopathic premature ventricular complexes: Comparison with a control group without intervention. Hear Rhythm. 2007;4(7):863-7. https://doi.org/10.1016/j.hrthm.2007.03.003 PMid:17599667 DOI: https://doi.org/10.1016/j.hrthm.2007.03.003

Gopinathannair R, Etheridge SP, Marchlinski FE, Spinale FG, Lakkireddy D, Olshansky B. Arrhythmia-induced cardiomyopathies mechanisms, recognition, and management. J Am Coll Cardiol. 2015;66(15):1714-28. https://doi.org/10.1016/j.jacc.2015.08.038 PMid:26449143 DOI: https://doi.org/10.1016/j.jacc.2015.08.038

Gopinathannair R, Sullivan R, Olshansky B. Tachycardiamediated cardiomyopathy: Recognition and management. Curr Heart Fail Rep. 2009;6(4):257-64. https://doi.org/10.1007/s11897-009-0035-3 PMid:19948094 DOI: https://doi.org/10.1007/s11897-009-0035-3

Sugumar H, Prabhu S, Voskoboinik A, Kistler PM. Arrhythmia induced cardiomyopathy. J Arrhythmia. 2018;34(4):376-383. https://doi.org/10.1002/joa3.12094 PMid:30167008 DOI: https://doi.org/10.1002/joa3.12094

Moore JP, Patel PA, Shannon KM, Albers EL, Salerno JC, Stein MA, et al. Predictors of myocardial recovery in pediatric tachycardia-induced cardiomyopathy. Hear Rhythm. 2014;11(7):1163-9. https://doi.org/10.1016/j.hrthm.2014.04.023 PMid:24751393 DOI: https://doi.org/10.1016/j.hrthm.2014.04.023

Pizzale S, Lemery R, Green MS, Gollob MH, Tang AS, Birnie DH. Frequency and predictors of tachycardia-induced cardiomyopathy in patients with persistent atrial flutter. Can J Cardiol. 2009;25(8):469-72. https://doi.org/10.1016/s0828-282x(09)70119-9 PMid:19668781 DOI: https://doi.org/10.1016/S0828-282X(09)70119-9

Ling LH, Kalman JM, Ellims AH, Iles LM, Medi C, Sherratt C, et al. Diffuse ventricular fibrosis is a late outcome of tachycardiamediated cardiomyopathy after successful ablation. Circ Arrhythm Electrophysiol. 2013;6(4):697-704. https://doi.org/10.1161/CIRCEP.113.000681 PMid:23884195 DOI: https://doi.org/10.1161/CIRCEP.113.000681

Shinbane JS, Wood MA, Jensen DN, Ellenbogen KA, Fitzpatrick AP, Scheinman MM. Tachycardia-induced cardiomyopathy: A review of animal models and clinical studies. J Am Coll Cardiol. 1997;29(4):709-15. https://doi.org/10.1016/s0735-1097(96)00592-x PMid:9091514 DOI: https://doi.org/10.1016/S0735-1097(96)00592-X

Coleman HN, Taylor RR, Pool PE, Whipple GH, Covell JW, Ross J Jr., et al. Congestive heart failure following chronic tachycardia. Am Heart J. 1971;81(6):790-8. https://doi.org/10.1016/0002-8703(71)90083-4 PMid:5088355 DOI: https://doi.org/10.1016/0002-8703(71)90083-4

O’Brien PJ, Ianuzzo CD, Moe GW, Stopps TP, Armstrong PW. Rapid ventricular pacing of dogs to heart failure: Biochemical and physiological studies. Can J Physiol Pharmacol. 1990;68(1):34-39. https://doi.org/10.1139/y90-004 PMid:2328442 DOI: https://doi.org/10.1139/y90-004

Gupta S, Figueredo VM. Tachycardia mediated cardiomyopathy: Pathophysiology, mechanisms, clinical features and management. Int J Cardiol. 2014;172(1):40-6. https://doi.org/10.1016/j.ijcard.2013.12.180 PMid:24447747 DOI: https://doi.org/10.1016/j.ijcard.2013.12.180

Watanabe H, Okamura K, Chinushi M, Furushima H, Tanabe Y, Kodama M, et al. Clinical characteristics, treatment, and outcome of tachycardia induced cardiomyopathy. Int Heart J. 2008;49(1):39-47. https://doi.org/10.1536/ihj.49.39 PMid:18360063 DOI: https://doi.org/10.1536/ihj.49.39

Mueller KA, Heinzmann D, Klingel K, Fallier-Becker P, Kandolf R, Kilias A, et al. Histopathological and immunological characteristics of tachycardia-induced cardiomyopathy. J Am Coll Cardiol. 2017;69(17):2160-72. https://doi.org/10.1016/j.jacc.2017.02.049 PMid:28449778 DOI: https://doi.org/10.1016/j.jacc.2017.02.049

Donghua Z, Jian P, Zhongbo X Donghua Z, Jian P, Zhongbo X, et al. Reversal of cardiomyopathy in patients with congestive heart failure secondary to tachycardia. J Interv Card Electrophysiol. 2013;36(1):27-32. https://doi.org/10.1007/s10840-012-9727-9 PMid:23090777 DOI: https://doi.org/10.1007/s10840-012-9727-9

Nerheim P, Birger-Botkin S, Piracha L, Olshansky B. Heart failure and sudden death in patients with tachycardiainduced cardiomyopathy and recurrent tachycardia. Circulation. 2004;110(3):247-252. https://doi.org/10.1161/01.CIR.0000135472.28234.CC PMid:15226218 DOI: https://doi.org/10.1161/01.CIR.0000135472.28234.CC

Huizar JF, Ellenbogen KA, Tan AY, Kaszala K. Arrhythmia-induced cardiomyopathy: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(18):2328-44. https://doi.org/10.1016/j.jacc.2019.02.045 PMid:31072578 DOI: https://doi.org/10.1016/j.jacc.2019.02.045

Raymond-Paquin A, Nattel S, Wakili R, Tadros R. Mechanisms and clinical significance of arrhythmia-induced cardiomyopathy. Can J Cardiol. 2018;34(11):1449-60. https://doi.org/10.1016/j.cjca.2018.07.475 PMid:30404750 DOI: https://doi.org/10.1016/j.cjca.2018.07.475

Duffee DF, Shen WK, Smith HC. Suppression of frequent premature ventricular contractions and improvement of left ventricular function in patients with presumed idiopathic dilated cardiomyopathy. Mayo Clin Proc. 1998;73(5):430-3. https://doi.org/10.1016/S0025-6196(11)63724-5 PMid:9581582 DOI: https://doi.org/10.1016/S0025-6196(11)63724-5

Loring Z, Hanna P, Pellegrini CN. Longer ambulatory ECG monitoring increases identification of clinically significant Ectopy. Pacing Clin Electrophysiol. 2016;39(6):592-597. https://doi.org/10.1111/pace.12852 PMid:27005323 DOI: https://doi.org/10.1111/pace.12852

Lee GK, Klarich KW, Grogan M, Cha YM. Premature ventricular contraction-induced cardiomyopathy: A treatable condition. Circ Arrhythm Electrophysiol. 2012;5(1):229-36. https://doi.org/10.1161/CIRCEP.111.963348 PMid:22334430 DOI: https://doi.org/10.1161/CIRCEP.111.963348

Engel G, Cho S, Ghayoumi A, Yamazaki T, Chun S, Fearon WF, et al. Prognostic significance of PVCs and resting heart rate. Ann noninvasive Electrocardiol. 2007;12(2):121-9. https://doi.org/10.1111/j.1542-474X.2007.00150.x PMid:17593180 DOI: https://doi.org/10.1111/j.1542-474X.2007.00150.x

Hasdemir C, Yuksel A, Camli D, Kartal Y, Simsek E, Musayev O, et al. Late gadolinium enhancement CMR in patients with tachycardiainduced cardiomyopathy caused by idiopathic ventricular arrhythmias. Pacing Clin Electrophysiol. 2012;35(4):465-70. https://doi.org/10.1111/j.1540-8159.2011.03324.x PMid:22303908 DOI: https://doi.org/10.1111/j.1540-8159.2011.03324.x

Mann SA, Castro ML, Ohanian M, Guo G, Zodgekar P, Sheu A, et al. R222Q SCN5A mutation is associated with reversible ventricular ectopy and dilated cardiomyopathy. J Am Coll Cardiol. 2012;60(16):1566-73. https://doi.org/10.1016/j.jacc.2012.05.050 PMid:22999724 DOI: https://doi.org/10.1016/j.jacc.2012.05.050

Ban JE, Park HC, Park JS, Nagamoto Y, Choi JI, Lim HE, et al. Electrocardiographic and electrophysiological characteristics of premature ventricular complexes associated with left ventricular dysfunction in patients without structural heart disease. Europace. 2013;15(5):735-41. https://doi.org/10.1093/europace/eus371 PMid:23194696 DOI: https://doi.org/10.1093/europace/eus371

Hwang JK, Park SJ, On YK, Kim JS, Park KM. Clinical characteristics and features of frequent idiopathic ventricular premature complexes in the Korean population. Korean Circ J. 2015;45(5):391-7. https://doi.org/10.4070/kcj.2015.45.5.391 PMid:26413107 DOI: https://doi.org/10.4070/kcj.2015.45.5.391

El Kadri M, Yokokawa M, Labounty T, Mueller G, Crawford T, Good E, et al. Effect of ablation of frequent premature ventricular complexes on left ventricular function in patients with nonischemic cardiomyopathy. Hear Rhythm. 2015;12(4):706-13. https://doi.org/10.1016/j.hrthm.2014.12.017 PMid:25527251 DOI: https://doi.org/10.1016/j.hrthm.2014.12.017

Gertz MA, Comenzo R, Falk RH, Fermand JP, Hazenberg BP, Hawkins PN, et al. Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): A consensus opinion from the 10th international symposium on amyloid and amyloidosis, Tours, France, 18-22 April 2004. J Hematol. 2005;79(4):319-28. https://doi.org/10.1002/ajh.20381 PMid:16044444 DOI: https://doi.org/10.1002/ajh.20381

Topaloglu S, Aras D, Cagli K, Yildiz A, Cagirci G, Cay S, et al. Evaluation of left ventricular diastolic functions in patients with frequent premature ventricular contractions from right ventricular outflow tract. Heart Vessels. 2007;22(5):328-34. https://doi.org/10.1007/s00380-007-0978-9 PMid:17879025 DOI: https://doi.org/10.1007/s00380-007-0978-9

Tung RT, Bauer B, Schelbert H, Lynch JP, Auerbach M, Gupta P, et al. Incidence of abnormal positron emission tomography in patients with unexplained cardiomyopathy and ventricular arrhythmias: The potential role of occult inflammation in arrhythmogenesis. Heart Rhythm. 2015;12(12):2488-98. https://doi.org/10.1016/j.hrthm.2015.08.014 PMid:26272522 DOI: https://doi.org/10.1016/j.hrthm.2015.08.014

Santhanakrishnan R, Wang N, Larson MG, Magnani JW, McManus DD, Lubitz SA, et al. Atrial fibrillation begets heart failure and vice versa: Temporal associations and differences in preserved versus reduced ejection fraction. Circulation. 2016;133(5):484-92. https://doi.org/10.1161/CIRCULATIONAHA.115.018614 PMid:26746177 DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.018614

Clark DM, Plumb VJ, Epstein AE, Kay GN. Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibrillation. J Am Coll Cardiol. 1997;30(4):1039-45. https://doi.org/10.1016/s0735-1097(97)00254-4 PMid:9316536 DOI: https://doi.org/10.1016/S0735-1097(97)00254-4

Cha YM, Redfield MM, Shen WK, Gersh BJ. Atrial fibrillation and ventricular dysfunction: A vicious electromechanical cycle. Circulation. 2004;109(23):2839-43. https://doi.org/10.1161/01.CIR.0000132470.78896.A8 PMid:15197156 DOI: https://doi.org/10.1161/01.CIR.0000132470.78896.A8

Prabhu S, Voskoboinik A, Kaye DM, Kistler PM. Atrial fibrillation and heart failure-cause or effect? Heart Lung Circ. 2017;26(9):967-74. https://doi.org/10.1016/j.hlc.2017.05.117 PMid:28684095 DOI: https://doi.org/10.1016/j.hlc.2017.05.117

Burke MA, Cook SA, Seidman JG, Seidman CE. Clinical and mechanistic insights into the genetics of cardiomyopathy. J Am Coll Cardiol. 2016;68(25):2871-86. https://doi.org/10.1016/j.jacc.2016.08.079 PMid:28007147 DOI: https://doi.org/10.1016/j.jacc.2016.08.079

Cahill TJ, Ashrafian H, Watkins H. Genetic cardiomyopathies causing heart failure. Circ Res. 2013;113(6):660-75. https://doi.org/10.1161/CIRCRESAHA.113.300282 PMid:23989711 DOI: https://doi.org/10.1161/CIRCRESAHA.113.300282

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the heart failure association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891-975. https://doi.org/10.1002/ejhf.592 PMid:27207191 DOI: https://doi.org/10.1093/eurheartj/ehw128

Di Biase L, Mohanty P, Mohanty S, Santangeli P, Trivedi C, Lakkireddy D, et al. Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device: Results from the AATAC multicenter randomized trial. Circulation. 2016;133(17):1637-44. https://doi.org/10.1161/CIRCULATIONAHA.115.019406 PMid:27029350 DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.019406

Pratt CM, Moyé LA. The cardiac arrhythmia suppression trial. Casting suppression in a different light. Circulation. 1995;91(1):245-247. https://doi.org/10.1161/01.cir.91.1.245 PMid:7805210 DOI: https://doi.org/10.1161/01.CIR.91.1.245

Zhong L, Lee YH, Huang XM, Asirvatham SJ, Shen WK, Friedman PA, et al. Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions: A single-center retrospective study. Heart Rhythm. 2014;11(2):187-193. https://doi.org/10.1016/j.hrthm.2013.10.033 PMid:24157533 DOI: https://doi.org/10.1016/j.hrthm.2013.10.033

Zecchin M, Muser D, Vitali-Serdoz L, Buiatti A, Morgera T. Arrhythmias in dilated cardiomyopathy: Diagnosis and treatment. In: Dilated Cardiomyopathy. Cham, CH: Springer; 2019. p. 149-71. https://doi.org/10.1007/978-3-030-13864-6_10 DOI: https://doi.org/10.1007/978-3-030-13864-6_10

Ling LH, Taylor AJ, Ellims AH, Iles LM, McLellan AJ, Lee G, et al. Sinus rhythm restores ventricular function in patients with cardiomyopathy and no late gadolinium enhancement on cardiac magnetic resonance imaging who undergo catheter ablation for atrial fibrillation. Heart Rhythm. 2013;10(9):1334-9. https://doi.org/10.1016/j.hrthm.2013.06.019 PMid:23811081 DOI: https://doi.org/10.1016/j.hrthm.2013.06.019

Fujino T, Yamashita T, Suzuki S, Sugiyma H, Sagara K, Sawada H, et al. Characteristics of congestive heart failure accompanied by atrial fibrillation with special reference to tachycardia-induced cardiomyopathy. Circ J. 2007;71(6):936-40. https://doi.org/10.1253/circj.71.936 PMid:17526993 DOI: https://doi.org/10.1253/circj.71.936