*2.4.1.4 Arrhythmia-induced DCM*

Tachycardia-induced cardiomyopathy was described more than 100 years ago by Gossage et al. as a reversible form of systolic dysfunction caused by long-lasting supraventricular or ventricular arrhythmias [42]. Ongoing rapid atrial or ventricular pacing may result in systemic changes by neurohormonal activation, characterized by reduction in serum sodium, activation of the renin-angiotensin system, and an increase of plasma atrial natriuretic peptide, aldosterone, and norepinephrine. Abnormal myocardial and cellular remodeling occurs, which may result in DCM. Furthermore, epinephrine can also lead to abnormal myocardial and cellular remodeling, which further result in biventricular dilatation, decreased contractility, and elevation of left and/or biventricular filling pressure [26].
