{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:51:54Z","timestamp":1753894314607,"version":"3.41.2"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJHP"],"abstract":"<jats:p>Background: Tachycardia-mediated cardiomyopathy (TMC) is a reversible form of heart failure with reduced ejection fraction (HFrEF), most commonly caused by atrial fibrillation or atrial flutter. Evidence for its management is scarce, and practice patterns are highly variable.\nObjective: To describe management patterns for HFrEF and atrial arrhythmias in patients with TMC at a specialty heart failure clinic. \nMethods: This retrospective cohort study involved adults with HFrEF and a physician-determined diagnosis of TMC, with an initial visit for this problem between October 2018 and October 2019. The 2 primary outcomes, evaluated at 1 year after the initial visit, were the proportion of patients receiving triple therapy (combination of angiotensin receptor\u2013neprilysin inhibitor [or angiotensin-converting enzyme inhibitor\/angiotensin II receptor blocker if ejection fraction improved to &gt;\u00a040% by 1\u00a0year], \u00df-blocker, and mineralocorticoid receptor antagonist at any dose) and the proportion receiving or with a plan to receive rhythm control. \nResults: A total of 59 participants met the inclusion criteria. The mean age was 73 years, 39 patients (66%) were male, and 42 (71%) had hypertension. At 1-year follow-up, 42 (71%) were receiving triple therapy, and rhythm control was attempted or planned for 20\u00a0(34%). Among the 17 patients (29%) not receiving triple therapy, a mineralocorticoid receptor antagonist was the agent most commonly\u00a0omitted. \nConclusions: In a specialty heart failure clinic, most patients with TMC were receiving triple therapy, with a mineralocorticoid receptor antagonist being the agent most commonly missing among those not receiving triple therapy. One-third of patients with TMC had received a rhythm-control strategy. These gaps in HFrEF therapy and rhythm control represent key areas for quality improvement initiatives in the management of patients with TMC.\nR\u00c9SUM\u00c9\nContexte\u00a0: La cardiomyopathie rythmique (CMR) est une forme r\u00e9versible d\u2019insuffisance cardiaque \u00e0 fraction d\u2019\u00e9jection r\u00e9duite (HFrEF), le plus souvent caus\u00e9e par la fibrillation auriculaire ou le flutter auriculaire. Les donn\u00e9es probantes relatives \u00e0 sa prise en charge sont rares et les mod\u00e8les de pratique sont tr\u00e8s variables.Objectif\u00a0: D\u00e9crire les sch\u00e9mas de prise en charge de l\u2019HFrEF et des arythmies auriculaires chez les patients atteints d\u2019une CMR dans une clinique sp\u00e9cialis\u00e9e en insuffisance cardiaque. \nM\u00e9thodes\u00a0: Cette \u00e9tude de cohorte r\u00e9trospective impliquait des adultes atteints d\u2019HFrEF et ayant re\u00e7u un diagnostic de CMR d\u00e9termin\u00e9 par un m\u00e9decin, avec une premi\u00e8re visite pour ce probl\u00e8me de sant\u00e9 entre octobre 2018 et octobre 2019. Les 2 r\u00e9sultats principaux, \u00e9valu\u00e9s 1 an apr\u00e8s la premi\u00e8re visite, \u00e9taient les suivants : 1) la proportion de patients recevant une trith\u00e9rapie (association r\u00e9cepteur de l\u2019angiotensine-n\u00e9prilysine (ARNi) [ou inhibiteur de l\u2019enzyme de conversion de l\u2019angiotensine\/antagoniste des r\u00e9cepteurs de l\u2019angiotensine II si la fraction d\u2019\u00e9jection s\u2019est am\u00e9lior\u00e9e \u00e0 &gt; 40 % \u00e0 1 an], un traitement par \u00df-bloquant et un antagoniste des r\u00e9cepteurs des min\u00e9ralocortico\u00efdes \u00e0 n\u2019importe quelle dose); et 2) la proportion recevant ou pr\u00e9voyant de recevoir un m\u00e9dicament antiarythmique. \nR\u00e9sultats\u00a0: Au total, 59 participants r\u00e9pondaient aux crit\u00e8res d\u2019inclusion. L\u2019\u00e2ge moyen \u00e9tait de 73 ans; 39 patients (66 %) \u00e9taient des hommes et 42 (71 %) avaient de l\u2019hypertension. Au marqueur d\u2019un an, 42 (71 %) recevaient une trith\u00e9rapie et un m\u00e9dicament antiarythmique a \u00e9t\u00e9 tent\u00e9 ou \u00e9tait pr\u00e9vu pour 20 (34 %) patients. Parmi les 17 patients (29 %) ne recevant pas de trith\u00e9rapie, l\u2019agent le plus souvent omis \u00e9tait l\u2019antagoniste des r\u00e9cepteurs des min\u00e9ralocortico\u00efdes. \nConclusions\u00a0: Dans une clinique sp\u00e9cialis\u00e9e dans l\u2019insuffisance cardiaque, la plupart des patients atteints d\u2019une CMR recevaient une trith\u00e9rapie, l\u2019antagoniste des r\u00e9cepteurs min\u00e9ralocortico\u00efdes \u00e9tant l\u2019agent le plus souvent absent chez ceux qui n\u2019en recevaient pas. Un tiers des patients atteints d\u2019une CMR avaient re\u00e7u un m\u00e9dicament antiarythmique. Ces lacunes concernant la th\u00e9rapie HFrEF et la gestion de l\u2019arythmie repr\u00e9sentent des domaines cl\u00e9s pour les initiatives d\u2019am\u00e9lioration de la qualit\u00e9 dans la prise en charge des patients atteints d\u2019une CMR.<\/jats:p>","DOI":"10.4212\/cjhp.3368","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T15:36:49Z","timestamp":1696347409000},"source":"Crossref","is-referenced-by-count":0,"title":["Management of Tachycardia-Mediated Cardiomyopathy: Experience from the Vancouver\u00a0General Hospital Cardiac Function Clinic (TMC-EXPLOR Study)"],"prefix":"10.4212","volume":"77","author":[{"given":"Aliya","family":"Daulat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"MacGillivray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Sidsworth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricky D","family":"Turgeon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2024,1,10]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3368\/5116","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3368\/5144","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3368\/5116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T18:11:16Z","timestamp":1705083076000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,10]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,10]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3368","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"type":"electronic","value":"1920-2903"},{"type":"print","value":"0008-4123"}],"subject":[],"published":{"date-parts":[[2024,1,10]]},"article-number":"e3368"}}