LONG TERM PROGNOSIS OF TACHYCARDIOMYOPATHY

Mar 28, 2019 Cardiotool Novità Fibrillazione Atriale Commenti disabilitati su LONG TERM PROGNOSIS OF TACHYCARDIOMYOPATHY

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Giulia Stronati, Federico Guerra, Alessandro Capucci- Institution: Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital “Umberto I-Lancisi-Salesi”, Ancona, Italy

ABSTRACT
BACKGROUND
Tachycardiomyopathy (TCMP) is an important cause of left ventricular dysfunction. It is defined as tachycardia induced cardiomyopathy as the impairment of the left ventricle is induced by atrial or ventricular arrhythmias.
The mechanisms of the cardiomyopathy are not fully recognised.
Early recognition and treatment are of paramount important given the possibility of reversal or partial reversibility of the condition. With regards to the prognosis and adverse events that can be linked to tachycardia induced cardiomyopathy, not many data are currently available in literature.
The aim of our study was to define long term prognosis of TCMP in a large single centre registry.
METHODS
Prospective single centre observational study enrolling all consecutive patients admitted with TCMP.
Inclusion criteria were:
-hospital admission for de novo acute heart failure with impaired LV (EF< 50%)
-evidence of atrial or ventricular tachyarrhythmia on admission
-improvement of at least one NYHA class and recovery of at least 5 points of EF after successful rate or rhythm control
We excluded patients who had a history of ischaemic heart disease, myocarditis, cardiomyopathy, valvular heart disease and congenital heart disease.
The patients were followed up for up to 5 years.
All patients were treated for heart failure and underwent rate or rhythm control strategies according to current guidelines.
RESULTS
131 patients, 69.5% males, were consecutively enrolled. Mean ventricular rate on admission was 124±16 bpm and mean LVEF was 30.5±9.5%.
During the admission 68 patients underwent electrical cardioversion, 12 pharmacological cardioversion, 17 catheter ablation and 34 were administered rate control strategies. At discharge mean ventricular rate was 72±16 bpm and mean LVEF was 39.6±9.8.
During follow up 53% of the patients experienced a new episode of high rate atrial or ventricular arrhythmia and 34% of all patients experienced a new episode of worsening heart failure.
No deaths were observed, however 4 patients developed thromboembolic events.
CONCLUSIONS
TCMP is usually considered as a benign reversible condition. However many patients experience further episodes of systolic dysfunction and/or tachyarrhythmic events during the following years.
Therefore a strict follow up is advisable in order to prevent complication.

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