Review ArticlesNovel Perspectives on Arrhythmia-Induced Cardiomyopathy Pathophysiology, Clinical Manifestations and an Update on Invasive Management StrategiesDella Rocca, Domenico G. MD*; Santini, Luca MD, PhD*; Forleo, Giovanni B. MD, PhD*; Sanniti, Aurora MD*; Del Prete, Armando MD*; Lavalle, Carlo MD†; Di Biase, Luigi MD, PhD‡§¶‖; Natale, Andrea MD‡§; Romeo, Francesco MD*Author Information From the *Division of Cardiology, Department of Internal Medicine, University of Rome “Tor Vergata”; †Department of Cardiology, San Filippo Neri Hospital, Rome, Italy; ‡Texas Cardiac Arrhythmia Institute at St. David’s Medical Center; §Department of Biomedical Engineering, University of Texas, Austin, TX; ¶Department of Cardiology, University of Foggia, Foggia, Italy; and ‖Albert Einstein College of Medicine at Montefiore Hospital, New York, NY. Disclosure: The authors declare no conflict of interest. Correspondence: Domenico G. Della Rocca, MD, Division of Cardiology, Department of Internal Medicine, University Hospital of Tor Vergata, Viale Oxford, 81, 00133, Roma, Italy. E-mail: [email protected]. Cardiology in Review: May/June 2015 - Volume 23 - Issue 3 - p 135-141 doi: 10.1097/CRD.0000000000000040 Buy Metrics Abstract Arrhythmia-induced cardiomyopathy is a partially or completely reversible form of myocardial dysfunction due to sustained supraventricular and ventricular arrhythmias. Asynchrony, rapid cardiac rates and rhythm irregularities are the main factors involved in the development of the disease. The reversible nature of arrhythmia-induced cardiac dysfunction allows only for a retrospective diagnosis of the disease once cardiac function is restored following heart rate control. A high level of suspicion is needed to make a diagnosis at an early stage and prevent further progression of the disease. Although reversible, arrhythmia-induced cellular and molecular changes may remain, increasing the risk for sudden death even when normal ejection fraction is restored as well as causing rapid deterioration of cardiac function and development of heart failure symptoms if arrhythmia recurs. Appropriate management based on a combination of pharmacologic and nonpharmacologic strategies to achieve rate control and prevent arrhythmia recurrence is pivotal to avoid further cardiac function deterioration and to control symptoms, significantly reducing the risk of heart failure and sudden cardiac death. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.