Why the study?
Pacing guidelines lack specific treatment options for infiltrative cardiac diseases like cardiac amyloidosis, leading to differing national and international recommendations amidst emerging disease-modifying therapies.
This review highlights the differing electrophysiologic changes seen in cardiac amyloidosis variants and discusses treatment options in the context of evolving disease-modifying therapies.
Amyloidosis is caused by deposition of abnormal amyloid fibrils with the feared consequence of end stage organ failure. Cardiac amyloidosis (CA) is an increasingly recognized antecedent of cardiomyopathy. CA is classified into transthyretin variants (ATTRwt – wild type and ATTRv – genetic variant) and a light chain variant (AL); each of these variants can be associated with unique electrophysiologic abnormalities. Pacing indications in current societal guidelines do not specify treatment options in infiltrative cardiac diseases, such as CA, and new disease modifying treatments are altering the landscape for intervention. Given the paucity of data, national and international groups have differing treatment options and recommendations. In this review, we aim to update and highlight the differing electrophysiologic changes seen in CA, their respective treatment course and suggest areas for future intervention.
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Martinez‐Parachini et al. (2022) studied this question.
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