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Predictors of myocardial recovery in arrhythmia-induced cardiomyopathy: A multicenter study

Rakesh Gopinathannair1, Rahul Dhawan2, Dhanunjaya R Lakkireddy1

  • 1Kansas City Heart Rhythm Institute, Overland Park, Kansas, USA.

Journal of Cardiovascular Electrophysiology
|February 24, 2021
PubMed

Insights

Low baseline left ventricular ejection fraction (LVEF) predicts recovery in arrhythmia-induced cardiomyopathy (AIC) patients. LVEF improved regardless of arrhythmia type or duration, but those with premature ventricular contractions (PVCs) showed less recovery.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Arrhythmia-induced cardiomyopathy (AIC) is a condition where abnormal heart rhythms impair left ventricular ejection fraction (LVEF).
  • Understanding predictors of LVEF recovery after treating the arrhythmia is crucial for patient management.

Purpose of the Study:

  • To identify predictors of LVEF recovery in a large, multicenter cohort of patients with AIC.
  • To evaluate the impact of arrhythmia type, duration, and baseline LVEF on treatment outcomes.

Main Methods:

  • A cohort of 243 patients with AIC caused by atrial fibrillation, atrial tachycardia, or premature ventricular contractions (PVCs) was analyzed.
  • LVEF was assessed before and after rhythm control treatment.
  • Patients were stratified by arrhythmia duration, type, baseline LVEF, and presence of structural heart disease (SHD).

Main Results:

  • LVEF improved post-treatment in all AIC patients, irrespective of arrhythmia duration or type.
  • Patients with PVC-induced AIC had lower baseline LVEF and less LVEF recovery compared to other groups.
  • Structural heart disease was associated with lower baseline and final LVEF.
  • Multivariate regression identified low baseline LVEF as a significant predictor of myocardial recovery (OR, 11.4; P < .005).

Conclusions:

  • LVEF recovery in AIC is possible across various arrhythmia types and durations.
  • Premature ventricular contractions (PVCs) may be associated with poorer LVEF recovery.
  • Low baseline LVEF is a key predictor of successful LVEF recovery following arrhythmia treatment.
Abstract

Keywords:
LVEF recoveryarrhythmiaarrhythmia-induced cardiomyopathycardiomyopathyleft ventricular ejection fraction

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