| Abstract [eng] |
Introduction. Tachycardia-induced cardiomyopathy is a condition, resulting from rapid and/or asynchronous/irregular myocardial contraction, manifesting as left ventricle dysfunction and heart failure symptoms and signs, which is partially or completely reversed after treatment of the causative arrhythmia. Tachycardia-induced cardiomyopathy is one of the very few reversible causes of heart failure, a life-threatening syndrome, affecting millions of people globally. Potentially reversible causes of heart failure should be widely known and vigorously investigated. Clinical case report. A clinical case of a 37-year-old man with tachycardia-induced cardiomyopathy is presented. The patient was diagnosed with atrial fibrillation, atrial flutter, and heart failure with a reduced left ventricular ejection fraction of 30%. The patient received treatment for heart failure, anticoagulation therapy, amiodarone, and restoration of sinus rhythm by electrical cardioversion. Later, due to recurrent episodes of atrial fibrillation and atrial flutter, pulmonary vein isolation and radiofrequency ablation of the atrial flutter were performed. After the treatment, the patient has no recurrences of arrhythmia, exhibits no symptoms and signs of heart failure, and the left ventricular ejection fraction has recovered (>55%). Discussion, Conclusions and Recommendations. The definition of tachycardia-induced cardiomiopathy varies in the medical literature. The prevalence and incidence of tachycardia-induced cardiomyiopathy are unclear and potentially underdiagnosed. Tachycardia-induced cardiomyopathy can be a result of various types of tachyarrhythmias, with atrial fibrillation being the most common cause in adults. The pathogenesis of tachycardia-induced cardiomyopathy is multifactorial. Tachycardia-induced cardiomyopathy can present at any age, involves symptoms related to tachycarrhythmia, heart failure, or both, and its presentation can vary from asymptomatic to heart failure with a reduced left ventricular ejection fraction. Patients should be thoroughly evaluated, which includes determining the concentration of B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide in the blood, performing electrocardiogram, Holter monitoring, echocardiography, and cardiac magnetic resonance imaging. Treatment of tachycardia-induced cardiomyopathy is focused on eliminating or controlling the tachycardia through maintenance of sinus rhythm or control of heart rate, along with anticoagulation and standard heart failure therapy. A major feature of tachycardia-induced cardiomyopathy is left ventricle dysfunction reversibility after successful tachyarrhythmia treatment. In the abscence of a precise definition of tachycardia-induced cardiomiopahy, sufficient data on epidemiology, etiology and pathogenesis, and specific guidelines for diagnosis and treatment, new scientific research is necessary to address these questions. |
