Tachycardia induced cardiomyopathy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and Keywords: chronotropic cardiomyopathy, tachycardiomyopathy
Overview
Tachycardia induced cardiomyopathy is a decline in left ventricular function and left ventricular dilation as a result of chronic or frequently recurring paroxysmal tachycardia. The tachycardia can either be an atrial tachycardia or a ventricular tachycarrhythmia. Depending upon the duration of the tachycardia, the condition is either completely or partially reversible.
Historical Perspective
The relationship between tachycardia and a reversible decline in left ventricular dysfunction was first described by Phillips and Levine in 1949 [1].
Pathophysiology
Animal models demonstrate that sustained atrial or ventricular pacing results in dilation of all four cardiac chambers with thinning of the left and right ventricular walls. Both diastolic and systolic dysfunction develops in all four chambers as well.
Risk Factors
The rate and duration of the elevation in heart rate necessary to cause a cardiomyopathy is unclear and is likely dependent on a number of unknown factors.
Prognosis
Depending upon the duration of the tachycardia, the condition is either completely or partially reversible.
Treatment
The primary treatment for a tachycardia induced cardiomyopathy is correct the underlying tachycardia. Supportive agents such as beta blockers and ACE inhibitors / angiotensin receptor blockers are of benefit to try to prevent remodeling of the left ventricle.
Not only is there a need to control the tachycardia that is responsible for causing tachycardia induced cardiomyopathy, but also treating underlying conditions that cause tachycardia. For instance, treatment of hyperthyroidism can also lead to reversal of tachycardia induced cardiomyopathy.
References
- ↑ Phillips E, Levine SA. Auricular fibrillation without other evidence of heart disease: a cause of reversible heart failure. Am J Med 1949; 7:478-89.