Tachycardia-Induced Cardiomyopathy in Patients With Idiopathic Ventricular Arrhythmias: The Incidence, Clinical and Electrophysiologic Characteristics, and the Predictors

• Published in: Journal of cardiovascular electrophysiology 2011-06, Vol.22 (6), p.663-668
• Main Authors: HASDEMIR, CAN, ULUCAN, CEM, YAVUZGIL, OGUZ, YUKSEL, ALPER, KARTAL, YILDIRIM, SIMSEK, EVRIM, MUSAYEV, OKTAY, KAYIKCIOGLU, MERAL, PAYZIN, SERDAR, KULTURSAY, HAKAN, AYDIN, MEHMET, CAN, LEVENT H.
• Format: Article
• Language: English
• Subjects: Cardiomyopathies - diagnosis; Cardiomyopathies - epidemiology; Comorbidity; Electrocardiography - statistics & numerical data; Female; Germany - epidemiology; Humans; Incidence; left ventricular outflow tract; Male; Middle Aged; premature ventricular complexes; right ventricular outflow tract; Risk Assessment; Risk Factors; Tachycardia, Ventricular - diagnosis; Tachycardia, Ventricular - epidemiology; tachycardia-induced cardiomyopathy; Ventricular Premature Complexes - diagnosis; Ventricular Premature Complexes - epidemiology; ventricular tachycardia
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/j.1540-8167.2010.01986.x

Idiopathic Ventricular Arrhythmias and Cardiomyopathy. Introduction: Idiopathic ventricular arrhythmias in the form of monomorphic premature ventricular contractions (PVC) and/or ventricular tachycardia (VT) can cause tachycardia‐induced cardiomyopathy (TICMP). The aim of this study was to determine the incidence, clinical and electrophysiologic characteristics, and the predictors of TICMP in patients with idiopathic ventricular arrhythmias. Methods: Study population consisted of 249 consecutive patients (148 F/101 M, 45 ± 20 y/o) with frequent PVCs and/or VT. All patients underwent transthoracic echocardiography and 24‐hour Holter monitoring. TICMP was defined as left ventricular ejection fraction (LVEF) of ≤50% in the absence of any detectable underlying heart disease and improvement of LVEF ≥15% following effective treatment of index ventricular arrhythmia. Results: Seventeen (6.8%) patients had TICMP. Patients with TICMP compared to patients with preserved LVEF were more likely to be male (65% vs 39%, P = 0.043) and asymptomatic (29% vs 9%, P = 0.018), and were more likely to have higher PVC burden (29.4 ± 9.2 vs 8.1 ± 7.4, P < 0.001), persistence of PVCs throughout the day (65% vs 22%, P = 0.001), and repetitive monomorphic VT (24% vs 0.9%, P < 0.001). PVC burden of 16% by ROC curve analysis best separated the patients with TICMP compared to patients with preserved LVEF (sensitivity 100%, specificity 87%, area under curve 0.96). Conclusions: TICMP was relatively common (∼1 in every 15 patients) in our study population. The predictors of TICMP were male gender, absence of symptoms, PVC burden of ≥16%, persistence of PVCs throughout the day, and the presence of repetitive monomorphic VT. (J Cardiovasc Electrophysiol, Vol. 22, pp. 663‐668, June 2011)