Key result
Catheter ablation improves LVEF across four distinct phenotypes of arrhythmia-induced cardiomyopathy to guide HF therapy.
Why the study?
Arrhythmia-induced cardiomyopathy (AIC) is an increasingly recognized and potentially reversible cause or modifier of heart failure, warranting a summary of experimental and clinical evidence focusing on atrial fibrillation-induced left ventricular systolic dysfunction.
This review synthesizes translational and clinical evidence on arrhythmia-induced cardiomyopathy and proposes a novel four-tier phenotyping framework for atrial fibrillation-related left ventricular dysfunction to guide individualized rhythm control and long-term heart failure medical therapy.
Answers are grounded in this paper and cite their sources.
Supports phenotyping arrhythmia-induced cardiomyopathy to guide ablation and HF decisions; leaves open prospective validation of phenotype-specific recovery.
Purpose of Review Arrhythmia-induced cardiomyopathy (AIC) is an increasingly recognized and potentially reversible cause or modifier of heart failure. This review summarizes experimental and clinical evidence with a focus on atrial fibrillation (AFib)-induced left ventricular systolic dysfunction. Recent Findings Recent studies demonstrate that AIC extends beyond tachycardia alone and involves rhythm irregularity, loss of atrioventricular synchrony, altered calcium handling, oxidative stress, mitochondrial dysfunction and substrate vulnerability. Clinical trials demonstrate the superiority of rhythm control therapy by catheter ablation in patients with AFib and heart failure. Emerging data illustrate the importance of phenotyping of AIC according to myocardial substrate and individual ventricular response to AFib. Summary AIC should be considered as a heterogeneous spectrum. Refined phenotyping may improve prediction of recovery and guide specific and individual therapy.
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Körtl et al. (2026) conducted a review in Arrhythmia-induced cardiomyopathy (AIC), specifically atrial fibrillation-induced left ventricular systolic dysfunction. Rhythm control therapy (catheter ablation) vs. Medical rate control or standard medical therapy was evaluated. Arrhythmia-induced cardiomyopathy encompasses four distinct clinical phenotypes where catheter ablation restores sinus rhythm and improves LVEF, guiding long-term heart failure therapy decisions.
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