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Low atrial tachycardia as primary cause of the heart failure complicating congestive cardiomyopathy.

A 50-years-old man with severe heart failure was diagnosed to have congestive cardiomyopathy and low atrial tachycardia at a fixed rate of 103 bpm. Conventional therapy for heart failure exerted a beneficial effect but complete clinical improvement was achieved only by reducing the rate of low atrial tachycardia with amiodarone. This suggests that in this situation tachycardia itself played a main role in the genesis of hemodynamic derangement.