Differentiation of Tachycardia Induced Cardiomyopathy and Dilated Cardiomyopathy

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The clinical manifestations of tachycardia-induced cardiomyopathy (TIC) and dilated cardiomyopathy (DCM) with tachyarrhythmia are similar. It is difficult to differentiate between them prior to treatment. We evaluated clinical data derived from 12-lead electrocardiography, echocardiography, and 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy of 21 patients with TIC (TIC group, 60.3±18.5 years, 11 males) and 24 patients with DCM (DCM group 51.7±18.6 years, 21 males). The ejection fraction (EF) prior to treatment was similar in both groups. However, the EF of the TIC group improved from 37.3±11.4% to 53.5±7.7% after treatment, while that of the DCM group did not improve. The left ventricular diastolic and systolic dimensions (LVDd & LVDs) were smaller in the TIC group than that in the DCM group (LVDd 51.7±6.7 mm vs 63.3±9.0 mm, LVDs 40.8±7.4 mm vs 53.6±10.1 mm, P<0.05). The QRS duration in aVR lead during tachycardia was longer in the DCM group than that in the TIC group (0.094±0.014 ms vs 0.074±0.011 ms, P<0.05). The washout ratio was higher in the DCM group than that in the TIC group (55.5±14.7% vs 31.4±8.1%, P<0.05). <B>Conclusion:</B> LVD at initial echocardiography, QRS duration in lead aVR, and the washout ratio may be useful in differentiating TIC from DCM in patients with left ventricular dysfunction and tachyarrhythmia.