Reversible cardiomyopathy-tachycardiomyopathy in children

Özet

Tachycardia-induced cardiomyopathy (tachycardiomyopathy) is definedby the presence of a sustained tachycardia that results in left ventricularsystolic dysfunction. Restoration of cardiac function is dependent on thecontrol of tachyarrhythmias. We report a series including ten children withtachycardia-induced cardiomyopathy with different etiologies. The medicalrecords of patients with tachycardiomyopathy who were managed in aPediatric Cardiology Clinic between the years of 2014-2017 were reviewedretrospectively. Ten children (3 female, 7 male) were diagnosed withtachycardiomyopathy. The median age of the patients was 12 years (range:4–15.8). Five had atrial tachycardia, two had ventricular tachycardia, theothers had Mahaim fiber tachycardia, permanent junctional reciprocatingtachycardia and atrioventricular reentrant tachycardia. Seven patients hadcatheter ablation and three patients who had previous heart surgery weretreated with antiarrhythmic drugs. Median ejection fraction was 33% (range:10-48), median left ventricle end-diastolic diameter was 55 mm (range: 30-78).All showed complete recovery with median ejection fraction 60% (range: 55-78). Two patient with severe heart failure required extracorporeal membraneoxygenation support, one of them had ventricular assist device support butthe device was removed after successful ablation. After two years this patientrequired permanent pacemaker implantation due to complete atrioventricularblock. Tachycardia-induced cardiomyopathy is a rare and treatable causeof heart failure. Early recognition is critical, aggressive treatment aimed atcontrolling the arrhythmia results in symptom resolution and recovery ofventricular function.