Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review (JACC June 2024-1)

Description

Arrhythmias frequently accompany heart failure and left ventricular dysfunction. Tachycardias, atrial fibrillation (AF), and premature ventricular contractions (PVCs) can induce a reversible form of dilated cardiomyopathy (CM) known as arrhythmia-induced CM (AiCM). The intriguing question is why certain individuals are more susceptible to AiCM despite similar arrhythmia burdens. The primary challenge is determining the extent of arrhythmias' contribution to LV systolic dysfunction. AiCM should be considered in patients with a mean heart rate exceeding 100 beats per minute, AF, or a PVC burden greater than 10%. Confirmation of AiCM occurs when CM reverses upon eliminating the responsible arrhythmia. Therapy choice depends on the specific arrhythmia, patient comorbidities, and preferences. After LV function is restored, ongoing follow-up is essential if an abnormal myocardial substrate persists. Accurate diagnosis and treatment of AiCM have the potential to enhance patients' quality of life, improve clinical outcomes, and reduce hospital admissions and overall healthcare costs.

Editors
Editor-in-Chief
Valentin Fuster, MD, PhD, MACC

CME Editor
Ragavendra R. Baliga, MD

Author
Kelvin Bush, MD, FACC

Important Dates
Date of Release: May 27, 2024
Term of Approval/Date of CME/MOC Expiration: May 26, 2025

Summary


Availability:	On-Demand
	Expires on May 26, 2025


Cost:	FREE


Credit Offered:	1 CME Credit 1 ABIM-MOC Point