title: Arrhythmia-Induced Cardiomyopathies: Mechanisms, Recognition, and Management.
abstract: Arrhythmia-induced cardiomyopathy (AIC) is a potentially reversible condition in which left ventricular dysfunction is induced or mediated by atrial or ventricular arrhythmias. Cellular and extracellular changes in response to the culprit arrhythmia have been identified, but specific pathophysiological mechanisms remain unclear. Early recognition of AIC and prompt treatment of the culprit arrhythmia using pharmacological or ablative techniques result in symptom resolution and recovery of ventricular function. Although cardiomyopathy in response to an arrhythmia may take months to years to develop, recurrent arrhythmia can result in rapid decline in ventricular function with development of heart failure, suggesting residual ultrastructural abnormalities. Reports of sudden death in patients with normalized left ventricular ejection fraction cast doubt on the complete reversibility of this condition. Several aspects of AIC, including specific pathophysiological mechanisms, predisposing factors, optimal therapeutic strategies to prevent ultrastructural changes, and long-term risk of sudden death remain unresolved and need further research.
authors.affiliation: Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky. Electronic address: rakesh.gopinathannair@louisville.edu.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Gopinathannair
authors.affiliation: Division of Pediatric Cardiology, University of Utah, Salt Lake City, Utah.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Etheridge
authors.affiliation: Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Francis E
authors.initials: FE
authors.lastname: Marchlinski
authors.affiliation: Department of Internal Medicine, University of South Carolina, Charleston, South Carolina.
authors.forename: Francis G
authors.initials: FG
authors.lastname: Spinale
authors.affiliation: Division of Cardiology, University of Kansas, Kansas City, Kansas.
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
authors.affiliation: Mercy Heart and Vascular Institute, Mercy Medical Center North Iowa, Mason City, Iowa.
authors.forename: Brian
authors.initials: B
authors.lastname: Olshansky
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000628:therapy; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000628:therapy*; D003935:Diagnostic Techniques, Cardiovascular; D019468:Disease Management; D006801:Humans
keywords: atrial fibrillation; atrial flutter; catheter ablation; heart failure; heart rate; tachycardia