Author + information
- Rahul Dhawan,
- Christopher R. Angus,
- Robert A. Pearce,
- Abbas Bitar,
- Brian Guinn,
- Dhanunjaya Lakkireddy,
- Brian Olshansky and
- Rakesh Gopinathannair
Background: Improvement in left ventricular ejection fraction (LVEF) can occur with prompt treatment of the culprit arrhythmia in patients with arrhythmia-induced cardiomyopathy (AIC). Predictors of recovery, however, are not well understood. We assessed the impact of arrhythmia duration and index LVEF on myocardial recovery in treated patients with AIC.
Methods: Of 56 patients with AIC (64±9 years; 82% male), the extent of LVEF recovery was compared between patients with known (KN, n=25) and unknown (UNK, n=31) arrhythmia duration, between the lowest and highest quartiles of the KN group, and between index LVEF quartiles. Values were expressed as mean±SD or median (IQR) and analyzed using two sample T-tests and the Wilcoxon rank sum test.
Results: AIC was due to atrial fibrillation in 61%, atrial flutter in 28%, and premature ventricular contractions in 11%. Structural heart disease (SHD) was present in 16 (29%) patients. No baseline differences were noted between the KN and UNK groups regarding clinical characteristics and index LVEF (31 % vs 27 %; p=0.1). The median arrhythmia duration before treatment was 386 days (IQR 1529). A rhythm control strategy was employed in 95% of patients. Median time from arrhythmia suppression to follow-up echocardiogram was 131 days. The degree of LVEF recovery from baseline was similar between the lowest and highest quartiles of arrhythmia duration (19.4±6.2% vs 20.4± 10.8%; p=0.8). The KN group had similar improvement in median LVEF compared to the UKN group (21 % vs 21 %; p=0.08). Patients in the lowest index LVEF quartile had similar degree of LVEF recovery following arrhythmia suppression when compared to the rest of the cohort (19.4± 6.3% vs 22.3± 8.3%; p=0.42). Median LVEF improved to a similar degree in patients with or without SHD (22.5  % vs 20.5 [14.5] %; p=0.36).
Conclusions: In this AIC cohort, treatment of the causal arrhythmia led to substantial improvement in LVEF regardless of known or unknown arrhythmia duration or the severity of index LVEF. Further, the presence of SHD did not affect the degree of recovery.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Arrhythmias and Clinical EP: Ventricular Tachycardia
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1108-080
- 2017 American College of Cardiology Foundation