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Tachycardia-mediated cardiomyopathy Persistent tachycardia of any form can cause tachycardia-mediated cardiomyopathy (TMC), can precipitate heart failure and can result in death [6]. If TMC is the direct consequence of tachycardia, it is referred to as tachycardia-induced cardiomyopathy or ��pure�� TMC [7]. Tachycardia can also worsen pre-existing cardiomyopathy (��impure�� TMC). TMC is partially or completely reversible, when measured by heart failure symptoms and left ventricular ejection fraction, once the culprit tachycardia is treated adequately. Tachycardias causing cardiomyopathy Any persistent tachycardia (Table 1) can result in TMC. Atrial fibrillation with persistent rapid ventricular rates is the most common cause [6,8]. Sinus tachycardia [http://www.selleckchem.com/screening/autophagy-signaling-compound-library.html Autophagy Compound Library] and POTS are usually not associated with TMC for unclear reasons. Thyrotoxicosis resulting in persistent sinus tachycardia or atrial fibrillation and consequent high output heart failure does not usually [http://www.selleckchem.com/products/dorsomorphin-2hcl.html Dorsomorphin] cause TMC [9]. Table 1. Arrhythmias responsible for tachycardia-mediated cardiomyopathy Management of a patient with tachycardia and cardiomyopathy The primary management strategy in TMC is focused on aggressive attempts to control tachycardia with the aim of improving heart failure symptoms and reversing left ventricular dysfunction [6]. Depending on the clinical condition of the patient and type of tachycardia, rate control and/or rhythm control strategies are usually employed. Underlying disease conditions, if present, should be optimized as much as possible and as soon as possible. If successful rate control or tachycardia elimination can reverse heart failure symptoms and cardiomyopathy, TMC is confirmed [8]. In patients with TMC, standard heart failure therapy (beta-blockers, angiotensin-converting enzyme inhibitors, and [http://en.wikipedia.org/wiki/Laccase Laccase] spironolactone) can attenuate neurohumoral response and affect favorable remodeling [6]. Rate control is commonly employed to manage atrial fibrillation causing TMC. Beta-blockers, calcium-channel antagonists and/or digoxin are commonly utilized for rate control. The optimal rate control strategy in TMC is yet to be identified, although a combination of drugs is often needed for adequate rate control; a beta-blocker combined with digoxin may have superior benefits [10,11]. The requirements for adequate rate control in TMC remain uncertain. In permanent atrial fibrillation, lenient rate control (resting ventricular rate