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Arrhythmia-Induced Cardiomyopathies

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Management of Cardiac Arrhythmias

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Arrhythmia-induced cardiomyopathy is a condition where sustained atrial and ventricular arrhythmias as well as ventricular ectopy result in cardiomyopathy and heart failure. Suppression/elimination of culprit arrhythmia results in partial or complete recovery of left ventricular (LV) function. This condition can develop in all age groups, in structurally normal hearts, and in patients with structural heart disease as well. Diagnosing the condition at clinical presentation is challenging and is usually accomplished following recovery of LV function with arrhythmia treatment. Thus, a very high index of suspicion is required for diagnosis. Early and aggressive treatment of culprit arrhythmias, with a focus on curative therapies, is warranted for recovery of LV function and improvement of symptoms. However, ultrastructural changes can persist following myocardial recovery resulting in vulnerability to recurrent arrhythmia and have implications toward long-term prognosis. Several knowledge gaps exist, especially regarding mechanistic understanding, early diagnosis, optimal management strategies, and long-term prognosis, and should guide future research.

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Abbreviations

AAD:

Anti-arrhythmic drugs

ACE:

Angiotensin-converting enzyme

AF:

Atrial fibrillation

AIC:

Arrhythmia-induced cardiomyopathy

AT:

Atrial tachycardia

AVNRT:

Atrioventricular nodal reentrant tachycardia

AVRT:

Atrioventricular reentrant tachycardia

CMP:

Cardiomyopathy

CRT:

Cardiac resynchronization therapy

HF:

Heart failure

ICD:

Implantable cardioverter defibrillator

JET:

Junctional ectopic tachycardia

LV:

Left ventricular/left ventricle

LVEDD:

Left ventricular end-diastolic diameter

LVEF:

Left ventricular ejection fraction

NT-pro-BNP:

N-terminal pro-B-type natriuretic peptide

PJRT:

Permanent junctional reciprocating tachycardia

POTS:

Postural orthostatic tachycardia syndrome

PVC:

Premature ventricular contraction

RV:

Right ventricular/right ventricle

SVT:

Supraventricular tachycardia

VT:

Ventricular tachycardia

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Rahul Dhawan

  2. Kansas City Heart Rhythm Institute, Overland Park, KS, USA

    Rakesh Gopinathannair

  3. University of Missouri-Columbia, Columbia, MO, USA

    Rakesh Gopinathannair

Authors
  1. Rahul Dhawan
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  2. Rakesh Gopinathannair
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Correspondence to Rakesh Gopinathannair .

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Editors and Affiliations

  1. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Gan-Xin Yan

  2. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Peter R. Kowey

  3. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Charles Antzelevitch

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Dhawan, R., Gopinathannair, R. (2020). Arrhythmia-Induced Cardiomyopathies. In: Yan, GX., Kowey, P., Antzelevitch, C. (eds) Management of Cardiac Arrhythmias. Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-030-41967-7_24

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