Arrhythmia-Induced Cardiomyopathy: Mechanisms and Risk Assessment to Guide Management and Follow-Up

AbstractPurpose of ReviewArrhythmia-induced cardiomyopathy (AIC) is a condition where left ventricular (LV) systolic dysfunction is caused by or worsened by atrial or ventricular arrhythmias. While recognition of AIC has grown over time, the identification of patients at risk for AIC remains an ongoing challenge. The purpose of this review is to explore mechanisms and types of AIC, discuss risk factors for the development of AIC, and features that predict clinical improvement.Recent FindingsPrompt recognition and treatment of the culprit arrhythmia can result in partial or complete recovery of LV function. In atrial fibrillation (AF), the movement towards early rhythm-control has been fueled by studies where catheter ablation decreases heart failure (HF) hospitalization, facilitates recovery of LV function, and reduces AF recurrence when compared to medical therapy. A recent multicenter study comparing an early rhythm-control strategy to usual care in AF found that early rhythm-control was associated with a lower risk of adverse outcomes including death from cardiovascular causes, stroke, or HF hospitalization. Integrating cardiac magnetic resonance (CMR) in the evaluation of non-ischemic cardiomyopathy may identify patients with AIC. In patients with AIC secondary to premature ventricular complexes (PVCs) or AF, the absence of late gadolinium enhancement (LGE) may predict recovery of LV function following arrhythmia treatment.SummaryRisk assessment for AIC requires character...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research