Domínguez-Rodríguez, Luis ManuelDobarro, DavidIglesias-Otero, CarlaCrespo-Leiro, María GenerosaRaposeiras-Roubín, SergioÁlvarez-García, JesúsBarreiro-Pérez, ManuelMuñoz-Pousa, IsabelSánchez-Recalde, ÁngelÍñiguez-Romo, AndrésZamorano, José Luis2025-04-012025-04-012024-12-18Domínguez-Rodríguez LM, Dobarro D, Iglesias-Otero C, Crespo-Leiro MG, Raposeiras-Roubín S, Álvarez-García J, Barreiro-Pérez M, Muñoz-Pousa I, Sánchez-Recalde A, Íñiguez-Romo Á, Zamorano JL. Guideline-directed medical therapy for heart failure in arrhythmia-induced cardiomyopathy with improved left ventricular ejection fraction. Eur J Heart Fail. 2025 Mar;27(3):442-452.1388-9842http://hdl.handle.net/2183/41603[Abstract] Aims: No study has analyzed the impact of guideline-directed medical therapy in preventing heart failure (HF) relapse in patients with arrhythmia-induced cardiomyopathy (AiCM) following left ventricular ejection fraction (LVEF) improvement. Methods and results: We analyzed data from a single-center cohort of 200 patients admitted for HF, LVEF <50% and cardiac arrhythmia considered by cardiologists to be the precipitating cause of the episode. The primary endpoint was time-to-HF relapse, defined as the composite of readmission for HF, Emergency Department (ED) visit for HF, or significant decline in LVEF. Changes in medication were recorded and a time-varying multivariate Cox regression was performed. After a median follow-up period of 6.14 years, diagnostic confirmation was achieved in 188 out of the initial 200 patients with suspected AiCM. A total of 89 patients (47.3%) met the primary endpoint. RAS inhibitors (adjusted hazard ratio (HR) 0.50 [0.31-0.81]; p = 0.005) and beta-blockers (adjusted HR 0.48 [0.28-0.81]; p = 0.006) were associated with a lower incidence of relapse. Mineralocorticoid receptor antagonists were associated with a significantly lower incidence of ED visits for HF (adjusted HR 0.38 [0.15-0.95]; p = 0.038), but did not achieve statistical significance for the combined primary endpoint. Antiarrhythmic drugs did not show a significant impact on the primary endpoint. Conclusion: Maintaining RAS inhibitors and beta-blockers was associated with a significantly lower incidence of relapse in the setting of AiCM with improved LVEF.engCreative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC-BY-NC-ND 4.0)http://creativecommons.org/licenses/by-nc-nd/3.0/es/Arrhythmia‐induced cardiomyopathyGuideline‐directed medical therapyHeart failureImproved ejection fractionTachycardia‐induced cardiomyopathyTachycardiomyopathy.journal articleopen access10.1002/ejhf.3556