What is tachycardia-induced cardiomyopathy and how can EP therapy help?

• A. Chronic tachyarrhythmias cause LV dysfunction; catheter ablation or rhythm control can reverse or improve LV function.
• B. Tachycardia does not affect LV function; EP therapy has no role.
• C. Tachycardia-induced cardiomyopathy is treated exclusively with heart transplant.
• D. EP therapy worsens LV function and should be avoided.

Answer: (A)

Tachycardia-induced cardiomyopathy is LV systolic dysfunction that arises from prolonged tachyarrhythmias. The key feature is that the heart’s pumping ability often recovers or improves once the tachycardia is controlled or eliminated.

EP therapy helps by reducing or removing the excessive heart rhythm burden. This is achieved through catheter ablation to cure or markedly reduce the arrhythmia, or by durable rhythm-control strategies to maintain sinus rhythm and a lower heart rate. By stopping the sustained fast rhythm, the myocardium can recover over weeks to months, reversing remodeling and improving LV function. This approach is commonly used for conditions like rapid atrial fibrillation, incessant atrial flutter, or incessant tachycardias that drive cardiomyopathy.

The other statements aren’t correct because tachycardia does affect LV function, transplant is not the typical first-line treatment for tachycardia-induced cardiomyopathy, and EP therapy can improve rather than worsen LV function.