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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Beyond arrhythmias: Exploring heart failure in arrhythmogenic cardiomyopathy

Marika Martini1, Marta Masini2, Ilaria Rigato1

  • 1Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.

International Journal of Cardiology
|June 29, 2026
PubMed

Insights

Heart failure (HF) in arrhythmogenic cardiomyopathy (ACM) indicates a severe condition with biventricular dysfunction. Identifying genetic (DSP), ECG, and imaging markers aids early risk identification for patients with ACM.

Area of Science:

  • Cardiology
  • Genetics
  • Heart Disease

Background:

  • Arrhythmogenic cardiomyopathy (ACM) is a genetic heart condition causing dangerous ventricular arrhythmias.
  • Increased survival in ACM patients due to improved therapies highlights heart failure (HF) as a growing clinical concern.

Purpose of the Study:

  • To characterize heart failure (HF) in patients with arrhythmogenic cardiomyopathy (ACM).
  • To identify clinical, electrocardiographic, imaging, and genetic variables associated with HF occurrence in ACM patients.

Main Methods:

  • Retrospective single-center study of 657 ACM patients diagnosed via 2010 Task Force and Padua criteria.
  • HF defined as hospitalization for HF symptoms; comparison of clinical, ECG, imaging, and genetic data between HF and non-HF groups.

Main Results:

  • Heart failure (HF) occurred in 7.3% of ACM patients.
  • HF patients showed more ECG abnormalities (T-wave inversions, low QRS voltages), higher prevalence of Desmoplakin (DSP) and Desmin variants, increased ventricular volumes, reduced biventricular systolic function, and higher arrhythmic burden.
  • Associated with HF: DSP variants (OR 3.08), low peripheral QRS voltages (OR 3.76), reduced LVEF (OR 0.89), and reduced RVEF (OR 0.93).

Conclusions:

  • Heart failure (HF) in ACM signifies a severe phenotype characterized by biventricular dysfunction and significant arrhythmic burden.
  • Genetic (DSP), electrocardiographic, and imaging markers can aid in early identification of high-risk ACM patients.
  • Early identification supports timely intervention strategies for ACM patients at risk of HF.
Abstract

Keywords:
Arrhythmogenic cardiomyopathy -heart failureGenetic - arrhythmias

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