Soubh Nibras, Rasenack Eva, Haarmann Helge, Zabel Markus, Bergau Leonard
Department of Cardiology and Pneumology, University Medical Center in Göttingen (UMG), Robert-Koch-Str. 40, 37085 Göttingen, Germany.
Eur Heart J Case Rep. 2025 Apr 15;9(4):ytaf151. doi: 10.1093/ehjcr/ytaf151. eCollection 2025 Apr.
Arrhythmia-induced cardiomyopathy (AiCM) is an increasingly recognized cause of heart failure. Atrial fibrillation and premature ventricular contractions are common causes of AiCM. Further, the use of wearable technology in arrhythmia detection is increasing steadily. In this case, we report on a patient suffering from AiCM as a result of frequent premature atrial contractions (PACs) detected by a wearable device.
A 34-year-old male, with no prior medical history, presented after his smartwatch detected frequent 'heart arrhythmias.' An initial electrocardiogram showed sinus rhythm with frequent PACs. Further evaluation revealed left ventricular dysfunction [left ventricular ejection fraction (LVEF) 35%]. Non-invasive tests ruled out coronary artery disease. Although the patient was initially asymptomatic, his condition worsened with a decline in LVEF to 15% despite optimal medical therapy. High-resolution 3D mapping identified the ectopic focus in the left inferior pulmonary vein, and radiofrequency ablation successfully eliminated the PACs. At the six-month follow-up, the patient was symptom-free with a recovered LVEF of 50%.
This case highlights the potential for frequent PACs to induce AiCM. Although PACs are typically considered benign, in this case, the high PAC burden led to significant left ventricular dysfunction. The successful resolution of the patient's symptoms and the improvement in heart function after radiofrequency ablation demonstrate the reversibility of AiCM caused by PACs if treated early. Importantly, this case underscores the emerging role of wearable technologies, like smartwatches, in the early detection of arrhythmias, enabling timely intervention to prevent the progression of heart failure.
心律失常性心肌病（AiCM）是心力衰竭日益被认识到的一个病因。心房颤动和室性早搏是AiCM的常见病因。此外，可穿戴技术在心律失常检测中的应用正在稳步增加。在此，我们报告一例因可穿戴设备检测到频繁房性早搏（PAC）而患有AiCM的患者。
一名34岁男性，既往无病史，在其智能手表检测到频繁“心律失常”后前来就诊。初始心电图显示窦性心律伴频繁PAC。进一步评估发现左心室功能障碍[左心室射血分数（LVEF）35%]。无创检查排除了冠状动脉疾病。尽管患者最初无症状，但尽管接受了最佳药物治疗，其病情仍恶化，LVEF降至15%。高分辨率三维标测确定了左下肺静脉的异位灶，射频消融成功消除了PAC。在六个月的随访中，患者无症状，LVEF恢复至50%。
本病例突出了频繁PAC诱发AiCM的可能性。尽管PAC通常被认为是良性的，但在本病例中，高PAC负荷导致了显著的左心室功能障碍。射频消融后患者症状成功缓解且心脏功能改善，表明如果早期治疗，PAC引起的AiCM具有可逆性。重要的是，本病例强调了智能手表等可穿戴技术在心律失常早期检测中的新作用，能够及时干预以防止心力衰竭进展。
