title: Tachycardia-induced cardiomyopathy in patients with idiopathic ventricular arrhythmias: the incidence, clinical and electrophysiologic characteristics, and the predictors.
abstract: BACKGROUND
  Idiopathic ventricular arrhythmias in the form of monomorphic premature ventricular contractions (PVC) and/or ventricular tachycardia (VT) can cause tachycardia-induced cardiomyopathy (TICMP). The aim of this study was to determine the incidence, clinical and electrophysiologic characteristics, and the predictors of TICMP in patients with idiopathic ventricular arrhythmias.
  
  
  METHODS
  Study population consisted of 249 consecutive patients (148 F/101 M, 45 ± 20 y/o) with frequent PVCs and/or VT. All patients underwent transthoracic echocardiography and 24-hour Holter monitoring. TICMP was defined as left ventricular ejection fraction (LVEF) of ≤50% in the absence of any detectable underlying heart disease and improvement of LVEF ≥15% following effective treatment of index ventricular arrhythmia.
  
  
  RESULTS
  Seventeen (6.8%) patients had TICMP. Patients with TICMP compared to patients with preserved LVEF were more likely to be male (65% vs 39%, P = 0.043) and asymptomatic (29% vs 9%, P = 0.018), and were more likely to have higher PVC burden (29.4 ± 9.2 vs 8.1 ± 7.4, P < 0.001), persistence of PVCs throughout the day (65% vs 22%, P = 0.001), and repetitive monomorphic VT (24% vs 0.9%, P < 0.001). PVC burden of 16% by ROC curve analysis best separated the patients with TICMP compared to patients with preserved LVEF (sensitivity 100%, specificity 87%, area under curve 0.96).
  
  
  CONCLUSIONS
  TICMP was relatively common (∼1 in every 15 patients) in our study population. The predictors of TICMP were male gender, absence of symptoms, PVC burden of ≥16%, persistence of PVCs throughout the day, and the presence of repetitive monomorphic VT.
authors.affiliation: Department of Cardiology, Ege University School of Medicine, Izmir, Turkey. can.hasdemir@yahoo.com
authors.forename: Can
authors.initials: C
authors.lastname: Hasdemir
authors.forename: Cem
authors.initials: C
authors.lastname: Ulucan
authors.forename: Oguz
authors.initials: O
authors.lastname: Yavuzgil
authors.forename: Alper
authors.initials: A
authors.lastname: Yuksel
authors.forename: Yildirim
authors.initials: Y
authors.lastname: Kartal
authors.forename: Evrim
authors.initials: E
authors.lastname: Simsek
authors.forename: Oktay
authors.initials: O
authors.lastname: Musayev
authors.forename: Meral
authors.initials: M
authors.lastname: Kayikcioglu
authors.forename: Serdar
authors.initials: S
authors.lastname: Payzin
authors.forename: Hakan
authors.initials: H
authors.lastname: Kultursay
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aydin
authors.forename: Levent H
authors.initials: LH
authors.lastname: Can
mesh_terms: D009202:Cardiomyopathies / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D004562:Electrocardiography / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000453:epidemiology*; D018879:Ventricular Premature Complexes / Q000175:diagnosis* / Q000453:epidemiology*