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Prevalence of arrhythmia-induced cardiomyopathy: A systematic review and meta-analysis

Teodor Serban1, Tatjana Müller1, Sven Knecht1

  • 1Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland.

Heart Rhythm
|December 6, 2025
PubMed

Insights

Arrhythmia-induced cardiomyopathy (AiCM) is a common cause of left ventricular systolic dysfunction (LVSD) in patients with arrhythmias, affecting 8% overall and 59% of those with LVSD. Standardized diagnostic criteria are needed for proper management.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Arrhythmia-induced cardiomyopathy (AiCM) is a reversible cause of left ventricular systolic dysfunction (LVSD) linked to sustained cardiac arrhythmias.
  • Historically, AiCM has been underestimated, with its true prevalence remaining largely unknown.

Purpose of the Study:

  • To determine the prevalence of AiCM across diverse patient groups.
  • To analyze how baseline patient characteristics influence AiCM development.
  • To evaluate the diagnostic criteria employed in existing clinical research.

Main Methods:

  • A systematic review and meta-analysis adhering to PRISMA guidelines.
  • Searches conducted across PubMed, MEDLINE, and Embase databases.
  • Quality assessment using the Newcastle-Ottawa scale and RoBINS-I tool; meta-regression for prevalence factors.

Main Results:

  • 26 studies with 7331 patients were analyzed; overall AiCM prevalence was 8%, rising to 59% in LVSD cohorts.
  • Prevalence varied with arrhythmia type and diagnostic criteria.
  • Higher baseline heart rates and specific patient demographics (age, LVEF) were associated with AiCM.

Conclusions:

  • AiCM is the leading cause of LVSD in patients experiencing arrhythmias.
  • The findings underscore the critical need for uniform diagnostic standards to guide effective patient management.
Abstract

Keywords:
Arrhythmia-induced cardiomyopathyAtrial fibrillationAtrial flutterEpidemiologyHeart failureMeta-analysisPrevalenceSystematic reviewTachycardiaTachymyopathy

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