Atrial fibrillation

2026-04-27T21:51:47Z

Rhythm Control

Supraventricular tachycardia

2026-04-27T17:08:57Z

Cardiomyopathy overview

2026-04-25T14:08:19Z

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	__NOTOC__		__NOTOC__
	{{Cardiomyopathy}}		{{Cardiomyopathy}}
	{{CMG}}; {{AE}} {{EdzelCo}}		{{CMG}}; {{AE}} {{EdzelCo}} {{MSD}}

	==Overview==		==Overview==
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	==Treatment==		==Treatment==
	===Medical Therapy===		===Medical Therapy===
	Treatment ~~depends~~ on the ~~type~~ of cardiomyopathy, ~~but may include medication~~, ~~implanted [[artificial pacemaker\|pacemakers]]~~, ~~[[Implantable cardioverter~~-~~defibrillator~~\|~~defribillators]]~~, ~~or [[ventricular assist device]]s (LVADs)~~, ~~or [[ablation]]~~. ~~The goal of treatment is often~~ symptom relief, and ~~some~~ patients ~~may eventually require a [[~~heart transplant]]. ~~Treatment~~ of ~~cardiomyopathy (~~and ~~other heart diseases) using alternative methods such as [[stem cell therapy]] is commercially available but is not supported by convincing evidence~~.		Treatment is phenotype-directed and includes guideline-directed medical therapy (GDMT) for heart failure syndromes and targeted therapy for specific cardiomyopathies such as hypertrophic cardiomyopathy (HCM). In HCM, management includes symptom-directed pharmacotherapy (beta-blocker or nondihydropyridine calcium-channel blocker, with disopyramide or a cardiac myosin inhibitor in selected adults with obstructive physiology), risk-based use of ICDs, and septal reduction therapy at experienced centers when symptoms persist despite medical therapy.<ref name="pmid38718139">{{cite journal \|vauthors=Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB \|title=2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=23 \|pages=e1239–e1311 \|date=June 2024 \|pmid=38718139 \|doi=10.1161/CIR.0000000000001250 \|url=}}</ref> <ref name="pmid35363499">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e895–e1032 \|date=May 2022 \|pmid=35363499 \|doi=10.1161/CIR.0000000000001063 \|url=}}</ref>For cardiomyopathy with HFrEF, foundational GDMT consists of an ARNI/ACE inhibitor/ARB, evidence-based beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor, with additional therapies and device-based treatment individualized by EF, QRS, symptoms, and comorbidities.<ref name="pmid35363499">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e895–e1032 \|date=May 2022 \|pmid=35363499 \|doi=10.1161/CIR.0000000000001063 \|url=}}</ref> Goals include symptom relief, prevention of sudden cardiac death (when relevant, e.g., HCM), and modification of heart-failure trajectory; patients with advanced heart failure despite GDMT should be referred to an advanced HF team for consideration of transplant and/or durable mechanical circulatory support.<ref name="pmid35363500">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e876–e894 \|date=May 2022 \|pmid=35363500 \|doi=10.1161/CIR.0000000000001062 \|url=}}</ref> In HCM with atrial fibrillation, oral anticoagulation is recommended irrespective of CHA₂DS₂-VASc, and rhythm and/or rate control should be individualized.<ref name="pmid38718139">{{cite journal \|vauthors=Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB \|title=2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=23 \|pages=e1239–e1311 \|date=June 2024 \|pmid=38718139 \|doi=10.1161/CIR.0000000000001250 \|url=}}</ref>

	===Surgery===		===Surgery===
	~~There~~ are ~~several types~~ of ~~surgery used~~ to ~~treat cardiomyopathy. They include~~ septal ablation, ~~[[septal myectomy]]~~, ~~surgically implanted devices to improve~~ the ~~function~~ of the ~~heart~~, ~~and [[heart transplant]]~~.		Procedural and surgical options are phenotype-specific and should be performed at experienced centers when indicated.<ref name="pmid38718139">{{cite journal \|vauthors=Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB \|title=2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=23 \|pages=e1239–e1311 \|date=June 2024 \|pmid=38718139 \|doi=10.1161/CIR.0000000000001250 \|url=}}</ref> For symptomatic obstructive HCM refractory to medical therapy, septal reduction therapy includes surgical septal myectomy or (in selected patients) alcohol septal ablation. Advanced heart failure may require durable mechanical circulatory support and/or heart transplantation after evaluation by an advanced HF team.<ref name="pmid38718139">{{cite journal \|vauthors=Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB \|title=2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=23 \|pages=e1239–e1311 \|date=June 2024 \|pmid=38718139 \|doi=10.1161/CIR.0000000000001250 \|url=}}</ref><ref name="pmid35363500">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e876–e894 \|date=May 2022 \|pmid=35363500 \|doi=10.1161/CIR.0000000000001062 \|url=}}</ref>

	===Primary Prevention===		===Primary Prevention===
	~~Methods of primary~~ prevention ~~for cardiomyopathy include; maintaining a healthy weight~~, ~~not smoking~~, ~~avoiding~~ alcohol and illicit drugs, ~~reducing stress~~, and ~~treating underlying conditions such as [[diabetes]] and [[high blood pressure]]~~.		Primary prevention focuses on ‘at risk’ (Stage A) and ‘pre-HF’ (Stage B) management: control hypertension, diabetes, obesity, and other cardiovascular risk factors; avoid cardiotoxins (including excess alcohol and illicit drugs); and treat structural heart disease early to prevent progression to symptomatic HF.<ref name="pmid35363500">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e876–e894 \|date=May 2022 \|pmid=35363500 \|doi=10.1161/CIR.0000000000001062 \|url=}}</ref><ref name="pmid38033089">{{cite journal \|vauthors=Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM, Deswal A, Eckhardt LL, Goldberger ZD, Gopinathannair R, Gorenek B, Hess PL, Hlatky M, Hogan G, Ibeh C, Indik JH, Kido K, Kusumoto F, Link MS, Linta KT, Marcus GM, McCarthy PM, Patel N, Patton KK, Perez MV, Piccini JP, Russo AM, Sanders P, Streur MM, Thomas KL, Times S, Tisdale JE, Valente AM, Van Wagoner DR \|title=2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=1 \|pages=e1–e156 \|date=January 2024 \|pmid=38033089 \|pmc=11095842 \|doi=10.1161/CIR.0000000000001193 \|url=}}</ref>

	==Preferences==		==Preferences==

wikidoc - Changes related to "Cardiomyopathy" [en]

Atrial fibrillation

Supraventricular tachycardia

Cardiomyopathy overview