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Warrick is a practicing cardiologist with a passion for improving care by helping patients understand heart health through education. Warrick believes educated patients get the best healthcare. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.
Hi, my name is Dr. Warrick Bishop, and I'd like to welcome you to my consulting room. Today, I'd like to speak with you a little bit about a concept that we call tachycardia-induced cardiomyopathy. That's a mouthful, so let me break it down for you. "Tachy" means fast. "Tachycardia", "cardia" relates to heart, so fast heart. Induced means the same whether it's referring to the medical term or common vernacular. "Cardia", referring to the heart, and myopathy referring to a problem with the muscle. So, fast heart-induced muscle problem, or Tachycardia-induced cardiomyopathy.
I'd like to speak about this because it can tie in with atrial fibrillation. We see it most commonly in people who have silent atrial fibrillation that is persistent, so the patients not necessarily aware of the rhythm, and it lasts for an extended period of time. What we find is that if the heart is being driven rapidly over its normal rate of 70 to 100 beats a minute. If it's rapidly being driven to 120, 30s, 40s, or even above. Then over time that heart actually suffers from being made to be too fast.
Over time, it starts to show features of fatigue and it starts to dilate, and starts to not be able to contract as effectively. We call that a cardio - Heart, myopathy - Muscle problem. So the muscle of the heart just gets fatigued or wears out. By the time we see these people, they're often short of breath and it's been gradual.
Their heart rate is very fast they have a dilated heart which we can pick up clinically on ECG and most clearly on cardiography, and they have features of heart failure and respond well to that. In these people, there can be different things that are causing their heart to have dilated. They may have had an infective process that's damaged the heart muscle; an infective cardiomyopathy. Or these people might have consumed too much alcohol; an alcoholic cardiomyopathy. Or it may be that it is related purely to their heart rate going fast. Sometimes we can't be sure.
But nonetheless, one of our mainstays of implementation of therapy is to slow that heart rate down. If we slow that heart rate down effectively and start to bring it back towards the 70-odd beats per minute, which is normal, then we can see a fantastic response. Sometimes these patients even respond better if we're able to restore sinus rhythm. That's another story, but sometimes we can do that. The really satisfying thing about this condition is if we are able to slow these people down for several months - say three months - then often they'll come back feeling much better and a re-evaluation of their heart shows a marked improvement in function. It is a very satisfying outcome and really a very good reminder of the significance of rapid prolonged heartbeat on the functioning of the heart.
Well, tachy-cardia induced cardiomyopathy can be seen in atrial fibrillation. Fortunately, it is often fully reversible and a very satisfying thing in terms of something to treat that gets better and in terms of the patient feeling better as well.
I hope you find that an interesting little piece on fast hearts and atrial fibrillation. I would really like to thank you for joining me and as always, I wish you the very best. Goodbye.
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