OBJECTIVES: This study aimed to characterize the incidence, clinical and electrophysiologic features, and long-term outcomes of patients with tachycardia-mediated cardiomyopathy (TCM) secondary to focal atrial tachycardia (AT). BACKGROUND: TCM is known to complicate atrial tachyarrhythmias. Little is known of the patient and tachycardia characteristics associated with the development of left ventricular (LV) dysfunction and the long-term outcomes after cure of tachycardia. METHODS: A total of 345 patients with focal AT underwent radiofrequency ablation between January 1997 and July 2008. A retrospective analysis was performed to identify patients with LV dysfunction, defined as an ejection fraction <50% on echocardiography. Patients with pre-existing structural heart disease (n = 14) were excluded. Patients with TCM (n = 30) and without TCM (n = 301) were compared. Recovery of LV function was also assessed. RESULTS: The incidence of TCM was 10%. Incessant or very frequent paroxysmal tachycardia was strongly associated with TCM, compared to patients without TCM (100% vs. 20%, p < 0.001). Patients in the TCM group were younger (mean age 39 +/- 22 years vs. 51 +/- 17 years, p = 0.0006) and more frequently male (60% vs. 38%, p < 0.001). Patients with TCM had a longer mean tachycardia cycle length (502 +/- 131 ms vs. 402 +/- 105 ms, p < 0.0001) and slower ventricular rate (117 +/- 21 beats/min vs. 141 +/- 33 beats/min, p = 0.0007) during tachycardia compared with patients who did not have TCM. Appendage sites are associated with a high incidence of incessant tachycardia (84%) and LV dysfunction (42%). After successful ablation, LV function was restored in 97% of patients at a mean of 3 months. CONCLUSIONS: Cardiomyopathy occurs in 10% of patients with focal AT. A slower incessant tachycardia is more frequently complicated by cardiomyopathy. Long-term restoration of LV function can be achieved after successful catheter ablation of the tachycardia focus.
OBJECTIVES: This study aimed to characterize the incidence, clinical and electrophysiologic features, and long-term outcomes of patients with tachycardia-mediated cardiomyopathy (TCM) secondary to focal atrial tachycardia (AT). BACKGROUND: TCM is known to complicate atrial tachyarrhythmias. Little is known of the patient and tachycardia characteristics associated with the development of left ventricular (LV) dysfunction and the long-term outcomes after cure of tachycardia. METHODS: A total of 345 patients with focal AT underwent radiofrequency ablation between January 1997 and July 2008. A retrospective analysis was performed to identify patients with LV dysfunction, defined as an ejection fraction <50% on echocardiography. Patients with pre-existing structural heart disease (n = 14) were excluded. Patients with TCM (n = 30) and without TCM (n = 301) were compared. Recovery of LV function was also assessed. RESULTS: The incidence of TCM was 10%. Incessant or very frequent paroxysmal tachycardia was strongly associated with TCM, compared to patients without TCM (100% vs. 20%, p < 0.001). Patients in the TCM group were younger (mean age 39 +/- 22 years vs. 51 +/- 17 years, p = 0.0006) and more frequently male (60% vs. 38%, p < 0.001). Patients with TCM had a longer mean tachycardia cycle length (502 +/- 131 ms vs. 402 +/- 105 ms, p < 0.0001) and slower ventricular rate (117 +/- 21 beats/min vs. 141 +/- 33 beats/min, p = 0.0007) during tachycardia compared with patients who did not have TCM. Appendage sites are associated with a high incidence of incessant tachycardia (84%) and LV dysfunction (42%). After successful ablation, LV function was restored in 97% of patients at a mean of 3 months. CONCLUSIONS:Cardiomyopathy occurs in 10% of patients with focal AT. A slower incessant tachycardia is more frequently complicated by cardiomyopathy. Long-term restoration of LV function can be achieved after successful catheter ablation of the tachycardia focus.
Authors: Amir M Nia; Natig Gassanov; Kristina M Dahlem; Evren Caglayan; Martin Hellmich; Erland Erdmann; Fikret Er Journal: Clin Res Cardiol Date: 2011-05-03 Impact factor: 5.460
Authors: Jack Christian Salerno; Stephen Paul Seslar; Terrence Ung Hoong Chun; Mina Vafaeezadeh; Andrea Rae Parrish; Lester Cal Permut; Gordon Alan Cohen; David Michael McMullan Journal: Pediatr Cardiol Date: 2011-03-30 Impact factor: 1.655
Authors: Liang-Han Ling; Peter M Kistler; Jonathan M Kalman; Richard J Schilling; Ross J Hunter Journal: Nat Rev Cardiol Date: 2015-12-10 Impact factor: 32.419