Premature atrial complex–induced cardiomyopathy: Case report and literature review

Elimination of premature atrial complexes can normalize left ventricular systolic function in Introduction Arrhythmia-induced cardiomyopathy is a reversible form of left ventricular (LV) systolic dysfunction caused by a high burden of atrial or ventricular arrhythmias. It most frequently occurs in patients with atrial fibrillation or premature ventricular complexes (PVCs). Impairment of LV systolic function secondary to frequent premature atrial complexes (PACs) has been rarely described. We present the case of a young man with frequent PACs and decrease in LV ejection fraction (LVEF). Catheter ablation successfully eliminated the PACs and LVEF subsequently normalized. Three similar cases reported in the literature are reviewed. In conjunction, these cases support the existence of reversible PAC-induced cardiomyopathy. patients with premature atrial complex–induced cardiomyopathy. Case report A 44-year-old man presented with several months of nearly constant palpitations and “skipped beats.” His past medical history was notable for hypertension and obesity, treated with gastric bypass surgery 9 years prior. His family history was significant for a father and brother with nonischemic cardiomyopathy. He denied alcohol and illicit drug use. One year prior to presentation, 12-lead electrocardiogram documented normal sinus rhythm. Echocardiogram demonstrated LVEF 65%, mild concentric LV hypertrophy, diastolic dysfunction, and mild biatrial dilation. Electrocardiogram performed to assess his current symptoms of palpitations was notable for sinus rhythm with frequent PACs (Figure 1). Holter monitoring documented 19% burden of unifocal PACs. Echocardiogram was now notable for LVEF 40%, without LV dilation or regional wall motion abnormalities. Coronary computed tomography