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J Cardiovasc Electrophysiol. 2014 Sep;25(9):953-957. doi: 10.1111/jce.12428. Epub 2014 May 11.

Tachycardiomyopathy complicated by focal atrial tachycardia: incidence, risk factors, and long-term outcome.

Author information

1
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Abstract

OBJECTIVE:

Focal atrial tachycardias (ATs) are known to have the potential to develop tachycardiomyopathy (TCM). The aim of the study was to investigate the incidence, risk factors, and long-term outcome of TCM patients complicated by focal ATs.

METHODS AND RESULTS:

A total of 237 patients undergoing electrophysiological studies were enrolled, among which 216 patients were diagnosed as focal ATs. In total, 18 patients (8.3%, 13 males) were identified to have TCM. The TCM patients were younger (29.8 ± 20.1 vs. 45.9 ± 17.3; P < 0.000) and were more frequently males (13/18 vs. 80/198; P = 0.014). The ATs were more likely to be persistent (11/18 vs. 32/198; P < 0.001). There was no difference between the 2 groups in terms of the tachycardia cycle length (392 milliseconds vs. 380 milliseconds; P = 0.56) and heart rate (144 bpm vs. 156 bpm; P = 0.15). The persistence and incidence of symptoms and prevalence of structural heart disease were comparable between the groups. In a multivariable analysis, the younger age and persistent nature were independently associated with TCM. In a 56 ± 21-month follow-up, all TCM patients had improved left ventricle ejection fraction after successful catheter ablation or medical therapy (43.9 ± 5.8% vs. 61.1 ± 3.5%; P < 0.05). However, 1 patient suffered sudden cardiac death due to unauthorized withdrawal of the drug and progressive heart failure.

CONCLUSIONS:

The incidence of TCM in focal ATs patients was 8.3%. Younger age and persistent nature were the independent risk factors of TCM. Most TCM patients had a benign outcome; however, long-term risk of sudden death does exist.

KEYWORDS:

atrial tachycardia; cardiomyopathy; catheter ablation; tachycardia-mediated cardiomyopathy

PMID:
24716793
DOI:
10.1111/jce.12428
[Indexed for MEDLINE]

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