Tachycardia-induced cardiomyopathy: A review of literature

Tachycardia-induced cardiomyopathy is a reversible cause of heart failure with myriad complex underlying mechanisms. In certain ways, this entity is similar to other causes of heart failure. The clinical manifestations, neurohumoral mechanisms, and treatment of this condition resemble heart failure from any other cause. However, in this case, treatment of the tachycardia responsible for the condition often results in clinical improvement and gross resolution of the heart failure; the literature on the microscopic reversal is scant. It is also unclear whether it scars the myocardium, which could increase the vulnerability to future development of heart failure. The importance of restoring and maintaining sinus rhythm, orat least controlling the ventricular rate in these patients cannot be overemphasized. In patients with pacemakers, using demand mode pacing and sequential dual-chamber pacing is important. Various available standard therapeutic options can help contain the damage and probably reverse it. Further research may discover more pivotal and focused therapeutic targets for intervention. In this condition, "sooner the better" applies to both diagnosis and treatment. A high index of suspicion, better understanding of underlying mechanisms, superior diagnostic and therapeutic options will lead to effective management of tachycardia-induced cardiomyopathy. Further research will help achieve these goals. Until then, heightened awareness of this condition, possible prevention, and judicious use of available options are our only hope to its management.