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. 2018 Jul 20;34(4):376-383.
doi: 10.1002/joa3.12094. eCollection 2018 Aug.

Arrhythmia induced cardiomyopathy

Hariharan Sugumar  1   2   3   4 , Sandeep Prabhu  1   2   3   4 , Aleksandr Voskoboinik  1   2   3   4 , Peter M Kistler  1   2   3   4
Affiliations

Arrhythmia induced cardiomyopathy

Hariharan Sugumar et al. J Arrhythm. .

Abstract

Arrhythmia induced cardiomyopathies (AIC) refer to the collective condition of Arrhythmia, Tachycardia, and ectopy-induced Cardiomyopathy. Atrial fibrillation (AF) and heart failure (HF) are modern epidemics that often coexist and exacerbate one another. We aim to provide an overview of the current understanding and evidence for treatment and management in AIC with a particular focus on AF-mediated cardiomyopathy and suggest approaches to recognize, screen, and manage AIC.

Keywords: arrhythmia; atrial fibrillation; cardiomyopathy; reversible; tachycardia.

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Figures

Figure 1
Figure 1
Mechanistic Overlap in AIC. Schematic representation of the mechanisms implicated in AIC with considerable overlap between these factors. AIC: Arrhythmia‐mediated cardiomyopathy, SVT: Supraventricular tachycardia, AF: Atrial fibrillation, PAC: Premature atrial complex, PVC: Premature ventricular complex, VT: Ventricular tachycardia, LBBB: Left bundle branch block
Figure 2
Figure 2
Cellular and Molecular Changes in Myocardium with Tachycardia. Time‐dependant and predictable cellular and molecular response to rapid ventricular pacing in animals that involve both extracellular matrix (ECM) and myocyte remodeling. There is loss of extracellular matrix and architecture that occurs over three phases: Compensatory (>7 days), LV dysfunction phase (1‐3 wk), LV failure (>3 wk). LV: Left ventricle. ATPase: adenosine triphosphatase; RAAS: renin‐angiotensin‐aldosterone system. (Credit: Reprinted from, JACC, Vol 66/Issue 15, Gopinathannair R et al, Arrhythmia‐Induced Cardiomyopathies Mechanisms, Recognition, and Management, Pages No1714‐1728., Copyright (2015), with permission from Elsevier)
Figure 3
Figure 3
Ectopic Atrial Tachycardia Sources. A schematic representation of the anatomic distribution of focal atrial tachycardias. CS: coronary sinus; CT: crista terminalis; LA: left atrium; LAA: left atrial appendage; MA: mitral annulus; PV: pulmonary vein; RA: right atrium; RAA: right atrial appendage; TA: tricuspid annulus. (Credit: Reprinted from, JACC, Vol 48 / Issue 5, Kistler, P et al, P‐Wave Morphology in Focal Atrial Tachycardia Development of an Algorithm to Predict the Anatomic Site of Origin, Pages No1010‐1017., Copyright (2006), with permission from Elsevier)
Figure 4
Figure 4
Management Algorithm for Suspected AIC. A flow diagram for the management of suspected arrhythmia induced cardiomyopathy is presented here. ECG: Electrocardiography, PVC: Premature ventricular contractions, AF: Atrial fibrillation, SVT: Supraventricular tachycardia, IHD: Ischemic heart disease, EAT: Ectopic atrial tachycardia
See this image and copyright information in PMC

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