Pacemaker-induced takotsubo cardiomyopathy

Takotsubo cardiomyopathy after left bundle branch pacing: A case report

“…However, unlike the previous cases, pacemaker implantation was an elective procedure, which was indicated for SND and not for atrioventricular block. 13 These cases emphasize typical features of TCM, such as prevalence in postmenopausal women, chest pain as a common symptom, ST-segment elevation (more frequently) or deep T-wave inversion on ECG, LV basal hyperkinesia, apical ballooning on echocardiogram and ventriculography, normal coronary angiography, and recovery of LV function within 3-4 weeks. However, our patient was a 93-year-old man who did not present with chest pain.…”

“…Although complete atrioventricular block could be implicated in triggering TCM, a routine outpatient procedure to implant a permanent pacemaker was indicated for SND in the case reported by Dashwood and colleagues. 13 The case presented here is emblematic in this setting because it reveals that this condition may be a result of pacemaker implantation also in male patients, presenting with a more severe form of acute heart failure, and may be associated with higher mortality rates in male patients than those observed in postmenopausal women. 2 However, Kurisu and colleagues 14 described 2 cases of TCM occurring after pacemaker implantation in postmenopausal women, who presented with persistent LV dysfunction, even during their convalescence at 2 and 4 months of follow-up.…”

“…2 In the literature, although uncommon, there are reported cases suggesting TCM as a potential complication of pacemaker implantation. 6,[11][12][13] Hsu and colleagues, 6 Gardini and colleagues, 11 and Postema and colleagues 12 reported cases of postmenopausal women who presented with TCM after undergoing pacemaker implantation owing to atrioventricular block, and cardiac function in these patients recovered to normal few weeks after the intervention. 6,11,12 Dashwood and colleagues 13 reported a case of a 76-yearold woman who developed TCM on the day after pacemaker implantation for sinus node dysfunction (SND).…”

“…Importantly, echocardiography revealed LVOT obstruction in the course of the treatment, and dealing with cardiogenic shock in such a situation in the ICU might be challenging because inotropes might worsen the obstruction by increasing IVPG and consequently deteriorate the hemodynamic parameters. 13 Figure 2 Echocardiogram recorded after left bundle branch pacing. Echocardiography performed to assess stroke volume through Simpson's method after left bundle branch pacing showing apical ballooning.…”

“…Dashwood and colleagues 13 reported a case of a 76-year-old woman who developed TCM on the day after pacemaker implantation for sinus node dysfunction (SND). Her cardiac function also recovered to normal within a few weeks after the procedure.…”