Year: 2025
Type: article
Study design: Case Report
Abstract: Background: Heart failure (HF) and atrial fibrillation often coexist and exacerbate each other, creating a therapeutic challenge when both are present. This case presents a patient with suspected tachycardia-induced cardiomyopathy (TIC) progressing to cardiogenic shock, managed with guideline-directed medical therapy (GDMT) for HF and pulmonary vein isolation (PVI) as an additional therapeutic pillar. Case summary: atrial fibrillation and TIC leading to cardiogenic shock. As rhythm control was initially unsuccessful, mechanical circulatory support was required despite GDMT. A thorough diagnostic work-up was performed, excluding coronary artery disease and structural heart diseases as underlying HF causes, making TIC the most likely diagnosis. After rhythm stabilization was achieved, haemodynamic stabilization followed subsequently. Later on, the patient underwent successful PVI. At the 12-month follow-up, no AF recurrence occurred, and the patient presented with HF with improved ejection fraction. Conclusion: Treatment of HF with GDMT should be performed simultaneously and harmonized with rhythm and rate control. This case highlights the role of early rhythm control and the potential of left ventricular ejection fraction improvement after PVI in patients with TIC.
Authors: Viktoria Santner, Martin Manninger, Anna-Sophie Eberl, Laura Stix, Daniel Scherr
Institution: Medical University of Graz
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $815
OpenAlex ID: W4415835700