Frequency and predictors of tachycardia-induced cardiomyopathy in patients with persistent atrial flutter

Pizzale, Stephen; Lemery, Robert; Green, Martin S.; Gollob, Michael H.; Tang, Antony; Birnie, David H.

doi:10.1016/s0828-282x(09)70119-9

Cited by 61 publications

(42 citation statements)

References 16 publications

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“…Until recently, TIC was considered to be a rare cause of reversible left ventricular (LV) dysfunction 1. Over the past few years, several publications have established that this disease is much more prevalent than once thought,2,03 but most reports of TIC have been isolated case reports or small retrospective cohorts comprising less than 20 to 30 patients.…”

mentioning

confidence: 99%

The clinical, electrocardiographic and echocardiographic characteristics and long-term outcome of patients with tachycardia-induced cardiomyopathy

Chin¹,

Badri²,

Ntusi³

et al. 2012

Cardiovascular Journal of Africa

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IntroductionThe clinical, electrocardiographic and echocardiographic features and long-term outcome of patients with tachycardia-induced cardiomyopathy (TIC) have not been well described in the past.MethodsA retrospective study was performed at our institution of patients with a diagnosis of TIC.ResultsThirty-three patients with pure TIC and 12 patients with impure TIC were identified. Compared to patients with dilated cardiomyopathy (DCMO), pure TIC patients were less symptomatic, as judged by NYHA class (p = 0.02), they had fewer clinical signs of heart failure (p = 0.007) and were more likely to report palpitations (p = 0.007) at presentation. Electrocardiographically, pure TIC patients had fewer Q waves (p = 0.002), less left ventricular hypertrophy (LVH) (p = 0.004) and repolarisation abnormalities (p = 0.048), and shorter QRS durations (p = 0.024). Echocardiographically, pure TIC patients had significantly smaller left ventricular internal diameter in diastole (LVIDd) (p < 0.001), ventricular internal diameter in systole (LVIDs) (p = 0.001) and left atrial dimensions (p = 0.048) at presentation compared to DCMO patients. Patients with pure TIC had a trend towards increased residual LVIDd dimensions compared to a control group with normal echocardiograms, indicating a persistence of adverse LV remodelling late after control of the causative tachycardia (p = 0.06). Recurrent tachycardia occurred in three patients, which resulted in a precipitous decline in left ventricular ejection fraction (LVEF).ConclusionsThis study is the first to compare features of pure and impure TIC. Patients with pure TIC had shorter QRS durations, fewer Q waves, and less LVH and repolarisation abnormalities at presentation compared to DCMO patients. TIC patients tended to have smaller LVIDd dimensions at presentation and have persistence of adverse LV remodelling, as characterised by persistent enlargement of LVIDd dimensions, at late follow up.

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mentioning

confidence: 99%

The clinical, electrocardiographic and echocardiographic characteristics and long-term outcome of patients with tachycardia-induced cardiomyopathy

Chin¹,

Badri²,

Ntusi³

et al. 2012

Cardiovascular Journal of Africa

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“…This is further supported by an observed decline in systolic function with cessation of cardiac remodeling medications (i.e., beta-blockers and angiotensin-converting enzyme inhibitors) even in the absence of tachycardia recurrence [48]. Finally, a small subset of treated SVT-related TIC patients had sudden cardiac death after resolution of ventricular dysfunction, supporting the observation of enduring cellular and molecular abnormalities [12 ]. Therefore, medical treatment should be indefinite, with close observation and frequent follow-up of SVT-related TIC patients.…”

Section: Resultsmentioning

confidence: 71%

“…This is supported by observations of precipitous decline in systolic function with recurrent arrhythmias, whereas the initial process took months or years to develop [12 ]. Such early recurrence of cardiac dysfunction is thought to be secondary to persistent cellular abnormalities, structural disarray, and diastolic dysfunction that persisted well after the tachycardia was treated and systolic function normalized [9 ,21,44].…”

Section: Resultsmentioning

confidence: 85%

Supraventricular tachycardia causing heart failure

Houmsse

Tyler

Kalbfleisch

2011

Current Opinion in Cardiology

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“…Of note, the degree of AF control in these patients was similar to that in patients with normal LV function, but they required more procedures (60). (65,66). In a study of 345 patients undergoing catheter ablation for focal atrial tachycardia, TMC was seen in 10% of cases (49).…”

Section: Diagnosis and Managementmentioning

confidence: 72%

Tachycardia mediated cardiomyopathy: Pathophysiology, mechanisms, clinical features and management

Gupta¹,

Figueredo²

2014

International Journal of Cardiology

110

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Frequency and predictors of tachycardia-induced cardiomyopathy in patients with persistent atrial flutter

Abstract: Sixteen of 28 (57%) cardiomyopathy patients with persistent atrial flutter had significantly improved LV function postablation. In 75% of these patients, LV function improved to normal.

Cited by 61 publications

References 16 publications

The clinical, electrocardiographic and echocardiographic characteristics and long-term outcome of patients with tachycardia-induced cardiomyopathy

The clinical, electrocardiographic and echocardiographic characteristics and long-term outcome of patients with tachycardia-induced cardiomyopathy

Supraventricular tachycardia causing heart failure

Tachycardia mediated cardiomyopathy: Pathophysiology, mechanisms, clinical features and management

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