RHYthm and Myocardial Function Relationship Evaluation in Heart Diseases

Registry record from ClinicalTrials.gov (NCT07491237). This is a study registration, not published results. Lead sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS. Recruitment status: RECRUITING. Study type: OBSERVATIONAL. Enrollment: 253 participants (ESTIMATED). Conditions: Arrhythmia, Cardiomyopathy, Dilated, Systolic Dysfunction, Atrial Fibrillation, Ventricular Arrythmia, Heart Failure, Cardiomyopathies. Interventions: DIAGNOSTIC_TEST: speckle tracking echocardiography. Primary outcome measures: analysis of pathophysiological mechanisms , 6 months; relationship between arrhythmias and cardiac function , 6 months. Brief summary: Arrhythmias are widespread among the global population. Although they can occur in healthy hearts, they are often the manifestation of a hereditary or acquired heart muscle disease, and may be the cause or, more often than not, the consequence. In recent decades, with advances in medical knowledge and technology, non-pharmacological therapies for arrhythmias have become increasingly popular. These fall into two broad categories: therapies aimed at electrostimulation and those aimed at ablation of arrhythmias. The selection of patients eligible for these procedures is essential for the effectiveness of the therapy, the reduction of complications and the optimisation of resources. Not all patients, even those selected according to guidelines, respond equally to the chosen therapy. Other patients, due to their clinical/ECG characteristics, do not have clear indications and remain in a borderline area where the class of evidence and/or recommendation of the guidelines is less stringent. Still others develop recurrences or complications during follow-up that require further intervention. In this context, it is essential in the study of these patients not only to use standard instrumental examinations, such as echocardiograms, Holter ECGs and stress tests (simple and cardiopulmonary), but also and above all to use advanced imaging methods (STE, 3D echo, MRI, CT, PET-CT) and remote monitoring tools that integrate diagnostic algorithms managed by artificial intelligence. In light of these considerations, our project consists of conducting an observational study that includes all patients with arrhythmias who are candidates for electrostimulation and/or ablation procedures at the Arrhythmology Unit and/or followed up at the Arrhythmology Clinic of our Polyclinic, in order to assess the clinical and/or imaging characteristics associated with a worse prognosis in this population, in terms of response to therapy and development of complications. Our main aim is to identify, within the above-mentioned population, the subgroups of responder patients versus non-responder patients, i.e. those with a worse prognosis , who deserve greater attention and more frequent follow-up.