Management of Arrhythmias and Conduction Disorders in Amyloid Cardiomyopathy.
Katarzyna HolcmanAndrzej ZąbekKrzysztof BoczarPiotr PodolecMagdalena KostkiewiczPublished in: Journal of clinical medicine (2024)
Cardiac amyloidosis, a condition characterized by abnormal protein deposition in the heart, leads to restrictive cardiomyopathy and is notably associated with an increased risk of arrhythmias and conduction disorders. This article reviews the current understanding and management strategies for these cardiac complications, with a focus on recent advancements and clinical challenges. The prevalence and impact of atrial arrhythmias, particularly atrial fibrillation, are examined, along with considerations for stroke risk and anticoagulation therapy. The article also addresses the complexities of managing rate and rhythm control, outlining the utility and limitations of pharmacological agents and interventions such as catheter ablation. Furthermore, it reviews the challenges in the treatment of ventricular arrhythmias, including the contentious use of implantable cardioverter-defibrillators for primary and secondary prevention. Individualized approaches, considering the unique characteristics of cardiac amyloidosis, are paramount. Continuous research and clinical exploration are essential to refine treatment strategies and improve outcomes in this challenging patient population.
Keyphrases
- atrial fibrillation
- catheter ablation
- left atrial
- heart failure
- left atrial appendage
- oral anticoagulants
- left ventricular
- congenital heart disease
- direct oral anticoagulants
- risk factors
- percutaneous coronary intervention
- multiple myeloma
- adipose tissue
- metabolic syndrome
- acute coronary syndrome
- coronary artery disease
- brain injury
- amino acid
- blood pressure
- subarachnoid hemorrhage
- binding protein
- cell therapy