Reversible cardiomyopathy-tachycardiomyopathy in children

Libyan Journal of Medicine, 2007

The term tachycardia-induced cardio-myopathy or tachycardiomyopathy refers to impairment in left ventricular function secondary to chronic tachycardia, which is partially or completely reversible once the tachyarrhythmia is controlled. Tachycardia-induced cardiomyopathy has been shown to occur both in experimental models and in patients with incessant tachyarrhythmia. Data from several studies and from case reports have shown that rate control by means of cardioversion, negative chronotropic agents, and surgical or catheter-based atrio-ventricular node ablation, resulted in significant improvement of systolic function. The diagnosis of tachycardia-induced cardiomyopathy is usually made following observation of marked improvement in systolic function after normalization of heart rate. Clinicians should be aware that patients with unexplained systolic dysfunction may have tachycardia-induced cardiomyo-pathy, and that controlling the arrhythmia may result in improvement of systolic function.

Journal of Interventional Cardiology, 1989

To evaluate the clinical response of five children with automatic atrial tachycardia (AA T) and associated cardiomyopathy to arrhythmia control, we compared pretreatment and posttreatment 24hour ECG heart rates, cardiothoracic ratio by chest radiograph, and echocardiographic measures of ventricular ,function. Two children were treated with amiodarone, two with surgical excision and cryoablation of the ectopic focus, and one with digoxin alone. Signijicantly slower mean heart rates were achieved, along with a dominant sinus rhythm and improvement in symptoms. Control of the AAT resulted in improved mean cardiothoracic ratio (0.53 pre vs 0.49 post; P = 0.021, as well as improvement in a number of echocardiographic measurements: mean shorten-ingfraction (20% pre vs 34% post; P = 0.006), mean ejection fraction (36% pre vs 50% post; P < 0.01), mean velocity of' circumferential fiber shortening (0.62 pre vs 1.20 post; P = 0.003). Mean E-point septa1 separation corrected for enddiastolic dimension also showed a trend toward improvement (0.25 pre vs 0.16 post; P = 0.11). Right ventricular endocardial biopsies in four were nonspecific; an atrial biopsy from surgery showed a Purkinje fiber-like tissue in one patient, but was nonspecijic in another. We conclude that cardiomyopathy can be causally linked to automatic atrial tachycardia and that aggressive medical and/or surgical management is warranted in those patients with signs and symptoms of impaired ventricular function. (J Interven Cardiol 1989:2:4)

ARYA atherosclerosis, 2014

Tachycardia-induced cardiomyopathy (TIC) is a rare cause of dilated cardiomyopathy (DCMP). The diagnosis can be missed because tachycardia is a common symptom in DCMP. We reviewed a case 5-year-old with palpitation and dyspnea with symptoms and signs of heart failure that diagnosed as DCMP initially. Then, in the evaluation for cause of tachycardia, atrial tachycardia was detected. Hence, treatment with flecainide was started and after 3 months, left ventricular (LV) systolic function and symptoms of the patient was relieved. TIC should be suspected in all patients with unexplained LV dysfunctions in the setting of a persistent tachyarrhythmia.

ACC Current Journal Review, 2004

Background-Tachycardia-induced cardiomyopathy is a reversible cause of heart failure. We hypothesized that although left ventricular ejection fraction measurements normalize after heart rate or rhythm control in patients with tachycardia-induced cardiomyopathy, recurrent tachycardia may have abrupt and deleterious consequences. Methods and Results-Patients with tachycardia-induced cardiomyopathy that developed over years were evaluated and treated. Tachycardia episodes and outcomes were assessed. Twenty-four patients were identified. All had NYHA functional class III heart failure or greater on presentation. One third were heart transplant candidates. There were 17 men and 7 women with a mean age of 46Ϯ16 years and mean left ventricular ejection fraction of 0.26Ϯ0.09 at the index visit. The cause was atrial fibrillation (nϭ13), atrial flutter (nϭ4), atrial tachycardia (nϭ3), idiopathic ventricular tachycardia (nϭ1), permanent junctional reciprocating tachycardia (nϭ2), and bigeminal ventricular premature contractions (nϭ1). Within 6 months of rate control or correction of the rhythm, left ventricular ejection fraction improved or normalized and symptoms abated in all. Five patients had tachycardia recur. In these patients, left ventricular ejection fraction dropped precipitously and heart failure ensued within 6 months, even though the initial impairment took years. Rate control eliminated heart failure and improved or normalized ejection fraction in 6 months. Three of 24 patients died suddenly and unexpectedly.

Cardiology and Angiology: An International Journal, 2020

Background: Tachycardiomyopathy is a non-familial cause of heart failure that can be reversible. A high index of suspicion is necessary for its diagnosis and for a rational approach in the management of patients. Aims: To describe the clinical profile and verify the treatment and outcome of a series of cases of patients with tachycardiomyopathy. Methodology: Among patients without previous ventricular dysfunction, those with tachycardiomyopathy were identified. They underwent clinical evaluation, complementary diagnostic tests, treatment and clinical follow-up. Results: 10 patients had tachycardiomyopathy, mean age 64.5 ± 11.5 years, 6 women. The arrhythmias were atrial fibrillation with a high heart rate (80%); atrial tachycardia with high heart rate and frequent ventricular premature beats. Mean baseline heart rate was 110.2 bpm and the ejection fraction was 36.8%. For heart rate control, all were treated with beta-blockers, in association with digoxin in 6 patients. It was necess...

Boletín médico del Hospital Infantil de México, 2013

Background. Idiopathic dilated cardiomyopathy is the most common form of cardiomyopathy in children; however, potentially reversible causes may occasionally be identifi ed. Among these is a group of patients with symptoms of congestive heart failure and persistent tachycardia representing a form of nonfamilial acquired cardiomyopathy known as tachycardia-induced cardiomyopathy or tachycardiomyopathy. This is a reversible condition with effective treatment of tachycardia. These patients may be misdiagnosed, potentially leading to inappropriate treatment. Diagnosis is often late and always should be suspected in patients with congestive heart failure and unexplained persistent tachycardia. Case reports. We describe six pediatric patients (mean age 12 +4 years old, range 6-16 years). Patients presented with clinical manifestations of congestive heart failure followed by dilated cardiomyopathy. Different mechanisms of persistent tachycardia were documented as the cause and total recover...

Journal of Cardiovascular Medicine, 2007

The prognosis of dilated cardiomyopathy is generally poor. The cause of ventricular dysfunction often cannot be identified. In most cases, the clinical history of cardiomyopathy is irreversible but, in some cases, potentially curable causes may be identified. The development of cardiomyopathy may be correlated to atrial or to ventricular arrhythmias. In this scenario, atrial fibrillation is the most frequent cause of ventricular dysfunction, even if it may also be secondary to heart failure. The diagnosis of tachycardia-induced cardiomyopathy can be made only after the improvement of the left ventricular function once the cardiac frequency has slowed down.

Congestive Heart Failure, 2010

Journal of The American College of Cardiology, 1990

PubMed, 1992

A case of severe dilated cardiomyopathy in a young boy presenting with incessant ventricular tachycardia, who had been referred for heart transplantation is reported. Complete resolution of dilated cardiomyopathy followed arrhythmia control with oral amiodarone. Such evolution strongly suggests a cause-effect relationship between incessant ventricular tachycardia and dilated cardiomyopathy in this particular case.