What is the management approach for tachycardia-induced cardiomyopathy?

• A. Rate/rhythm control and treating HF
• B. Immediate heart transplant
• C. Observation only
• D. High-sodium diet

Answer: (A)

Tachycardia-induced cardiomyopathy improves when the heart is relieved from the ongoing tachycardia, so the management centers on reducing the heart rate or restoring a normal rhythm while also treating the heart failure itself. This means using rate control or rhythm-control strategies to lower the tachycardia burden—such as beta-blockers (with careful titration in heart failure), and, when appropriate, antiarrhythmic therapy, cardioversion, or ablation to achieve or maintain sinus rhythm. At the same time, employ guideline-directed heart failure therapy to support ventricular function—ACE inhibitors or ARBs or ARNIs, beta-blockers, mineralocorticoid receptor antagonists, and diuretics for congestion—tailored to the patient’s hemodynamics. The combination often leads to reverse remodeling and recovery of LV function over weeks to months. Transplantation is not the initial approach unless HF is truly end-stage and not reversible, and simply observing or adopting a high-sodium diet would not address the underlying problem.