title: Novel perspectives on arrhythmia-induced cardiomyopathy: pathophysiology, clinical manifestations and an update on invasive management strategies.
abstract: Arrhythmia-induced cardiomyopathy is a partially or completely reversible form of myocardial dysfunction due to sustained supraventricular and ventricular arrhythmias. Asynchrony, rapid cardiac rates and rhythm irregularities are the main factors involved in the development of the disease. The reversible nature of arrhythmia-induced cardiac dysfunction allows only for a retrospective diagnosis of the disease once cardiac function is restored following heart rate control. A high level of suspicion is needed to make a diagnosis at an early stage and prevent further progression of the disease. Although reversible, arrhythmia-induced cellular and molecular changes may remain, increasing the risk for sudden death even when normal ejection fraction is restored as well as causing rapid deterioration of cardiac function and development of heart failure symptoms if arrhythmia recurs. Appropriate management based on a combination of pharmacologic and nonpharmacologic strategies to achieve rate control and prevent arrhythmia recurrence is pivotal to avoid further cardiac function deterioration and to control symptoms, significantly reducing the risk of heart failure and sudden cardiac death.
authors.affiliation: From the *Division of Cardiology, Department of Internal Medicine, University of Rome "Tor Vergata"; †Department of Cardiology, San Filippo Neri Hospital, Rome, Italy; ‡Texas Cardiac Arrhythmia Institute at St. David's Medical Center; §Department of Biomedical Engineering, University of Texas, Austin, TX; ¶Department of Cardiology, University of Foggia, Foggia, Italy; and ‖Albert Einstein College of Medicine at Montefiore Hospital, New York, NY.
authors.forename: Domenico G
authors.initials: DG
authors.lastname: Della Rocca
authors.forename: Luca
authors.initials: L
authors.lastname: Santini
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Forleo
authors.forename: Aurora
authors.initials: A
authors.lastname: Sanniti
authors.forename: Armando
authors.initials: A
authors.lastname: Del Prete
authors.forename: Carlo
authors.initials: C
authors.lastname: Lavalle
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000628:therapy; D009202:Cardiomyopathies / Q000209:etiology* / Q000628:therapy; D019468:Disease Management; D006801:Humans; D017410:Practice Guidelines as Topic