Tachycardiomyopathy: Clinical Profile, Treatment and Outcome of a Series of Clinical Cases

Main Article Content

Rose Mary Ferreira Lisboa da Silva
Sara Magro Borigato
Ítala Ferreira de Jesus
Giovanni Oliveira Carvalho
Mariana Alves Gomes
Raissa Alves Pinto Moura
Isabella Capobiango Rodrigues

Abstract

Background: Tachycardiomyopathy is a non-familial cause of heart failure that can be reversible. A high index of suspicion is necessary for its diagnosis and for a rational approach in the management of patients.

Aims: To describe the clinical profile and verify the treatment and outcome of a series of cases of patients with tachycardiomyopathy.

Methodology: Among patients without previous ventricular dysfunction, those with tachycardiomyopathy were identified. They underwent clinical evaluation, complementary diagnostic tests, treatment and clinical follow-up.

Results: 10 patients had tachycardiomyopathy, mean age 64.5 ± 11.5 years, 6 women. The arrhythmias were atrial fibrillation with a high heart rate (80%); atrial tachycardia with high heart rate and frequent ventricular premature beats. Mean baseline heart rate was 110.2 bpm and the ejection fraction was 36.8%. For heart rate control, all were treated with beta-blockers, in association with digoxin in 6 patients. It was necessary to implant a pacemaker in VVI mode        (V: ventricle is stimulated, V: ventricle sensed; I: inhibiting response) and ablation of the atrioventricular node in 2 patients with persistent atrial fibrillation. After a mean 27.6 months, the mean heart rate was 76.5 bpm (p <0.0001, paired t-test) and there was clinical improvement of all patients. There was an average increase of 9.6% in the left ventricular ejection fraction. Despite this, 4 patients still had ventricular dysfunction (3 of them developed comorbidities).

Conclusion: In this series, the main cause of tachycardiomyopathy was atrial fibrillation with high heart rate. Similar to the description of literature, there was remission of symptoms with restore normal heart rhythm or control heart rate.

Keywords:
Tachycardiomyopathy, tachycardia-induced cardiomyopathy, heart failure, atrial fibrillation, reversible, tachycardia.

Article Details

How to Cite
Silva, R. M. F. L. da, Borigato, S. M., Jesus, Ítala F. de, Carvalho, G. O., Gomes, M. A., Moura, R. A. P., & Rodrigues, I. C. (2020). Tachycardiomyopathy: Clinical Profile, Treatment and Outcome of a Series of Clinical Cases. Cardiology and Angiology: An International Journal, 9(2), 16-20. https://doi.org/10.9734/ca/2020/v9i230131
Section
Case Report

References

Martin CA, Lambiase PD. Pathophysiology, diagnosis and treatment of tachycardiomyopathy. Heart. 2017;103(19):1543-1552.
Available:https://www.ncbi.nlm.nih.gov/pubmed/28855272

Simantirakis EN, Koutalas EP, Vardas PE. Arrhythmia-induced cardiomyopathies: The riddle of the chicken and the egg still unanswered? Europace. 2012;14(4):466-73.
Available:https://www.ncbi.nlm.nih.gov/pubmed/26449143

Gopinathannair R, Etheridge SP, Marchlinski FE, Spinale FG, Lakkireddy D, Olshansky B. Arrhythmia-induced cardiomyopathies: Mechanisms, recogni-tion and management. J Am Coll Cardiol. 2015;66(15):1714-28.
Available:https://www.ncbi.nlm.nih.gov/pubmed/26449143

Latchamsetty R, Bogun F. Premature ventricular complex-induced cardio-myopathy. JACC Clin Electrophysiol. 2019;5(5):537-550.
Available:https://www.ncbi.nlm.nih.gov/pubmed/31122375

Allen HW. Auricular fibrillation. Cal State J Med. 1913;11(12):496-9.
Available:https://www.ncbi.nlm.nih.gov/pubmed/18736122

Elliott P. Defining tachycardia-induced cardiomyopathy: Life in the fast lane. J Am Coll Cardiol. 2017;69(17):2173-2174.
Available:https://www.ncbi.nlm.nih.gov/pubmed/28449779

Panizo JG, Barra S, Mellor G, Heck P, Agarwal S. Premature ventricular complex-induced cardiomyopathy. Arrhythm Electrophysiol Rev. 2018;7(2):128-134.
Available:https://www.ncbi.nlm.nih.gov/pubmed/29967685

Sossalla S, Vollmann D. Arrhythmia-induced cardiomyopathy. Dtsch Arztebl Int. 2018;115(19):335-341.
Available:https://www.ncbi.nlm.nih.gov/pubmed/29875055

Pachón M, Arias MA, Pérez-Serradilla A. Tachycardiomyopathy induced by nonreentrant nodal tachycardia. Rev Esp Cardiol (Engl Ed). 2014;67(7):57.
Available:https://www.ncbi.nlm.nih.gov/pubmed/24952400

Peters S. Tachycardiomyopathy: A case of dilated cardiomyopathy due to permanent junctional reentrant tachycardia. Int J Cardiol. 2016;207:233-4.
Available:https://www.ncbi.nlm.nih.gov/pubmed/26803254

Minciuna IA, Puiu M, Cismaru G, Gusetu G, Comsa H, Caloian B, Zdrenghea D, Pop D, Radu R. Tachycardia-induced cardiomyopathy in a patient with left-sided accessory pathway and left bundle branch block: A case report. Medicine (Baltimore). 2019;98(32):e16642.
Available:https://www.ncbi.nlm.nih.gov/pubmed/31393361

Raymond-Paquin A, Nattel S, Wakili R, Tadros R. Mechanisms and clinical significance of arrhythmia-induced cardio-myopathy. Can J Cardiol. 2018;34(11): 1449-1460.
Available:https://www.ncbi.nlm.nih.gov/pubmed/30404750

Montero S, Ferrero-Gregori A, Cinca J, Guerra JM. Long-term outcome of patients with tachycardia-induced cardiomyopathy after recovery of left ventricular function. Rev Esp Cardiol (Engl Ed). 2018;71(8): 681-683.
Available:https://www.ncbi.nlm.nih.gov/pubmed/28669768