Permanent Pacemaker Implantation in a Patient with Takotsubo Cardiomyopathy and Complete Atrioventricular Block

Terui, Toshihiro; Iwai-Takano, Masumi; Watanabe, Tomoyuki

doi:10.1155/2021/6637720

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…A crucial question about the link between TTS and CHB remains unanswered, as there are several possibilities: CHB is a physiological stressor that triggers TTS or TTS causes CHB, or the link is accidental with no causality. Several case reports can be found in the literature, some documenting CHB as a cause of TTS and others noting vice-versa [4][5][6][7][8]. Our case is unique since we can document the temporal relationship between the rhythm disturbance and the subsequent TTS.…”

Section: Discussionmentioning

confidence: 67%

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Complete Heart Block Causing Takotsubo Syndrome: A Case Report

Jasti¹,

Petrasko²,

Stys³

et al. 2022

Cureus

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The association of complete atrioventricular (AV) block with Takotsubo syndrome (TTS) is well known, but the cause-and-effect relationship has not been determined. We present the case of a 91-year-old female with complete AV block who went untreated for over a year and later developed Takotsubo syndrome. Reversal of wall movement defects was seen after a permanent pacemaker was implanted, and routine follow-up showed that the implanted pacemaker worked normally.

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Section: Discussionmentioning

confidence: 67%

“…The exact cause is unknown, but catecholamine excess and sympathetic nervous system overactivity are potential contributors [2,3]. Several cases of TTS associated with complete heart block (CHB) have been reported in the literature [4][5][6][7][8]. Their possible cause-and-effect relationship, however, has yet to be explained.…”

Section: Introductionmentioning

confidence: 99%

Complete Heart Block Causing Takotsubo Syndrome: A Case Report

Jasti¹,

Petrasko²,

Stys³

et al. 2022

Cureus

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show abstract

“…The decision regarding implanting a permanent pacemaker (PPM) is clinically justified. Most of the reported cases acquired PPM despite the recovery of SIC [5][6][7]. Our patient was relatively young with no known history of conductive or infiltrative diseases.…”

Section: Discussionmentioning

confidence: 82%

The Fatal Interplay between Stress Induced Cardiomyopathy, Arrhythmia and Cardiogenic Shock

Khabsa,

Al Kalaji,

Rasheed

et al. 2023

J Clin Cardiol

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“…A handful of reports have described TCM patients presenting with third-degree AV blocks [12,20,[23][24][25]. Most cases of complete AV block associated with TCM have been described in elderly individuals, who are more prone to have a degenerative conductive system disease.…”

Section: Discussionmentioning

confidence: 99%

The Ominous Triad of Severe Takotsubo Cardiomyopathy

Awadelkarim¹,

Yassin²,

Ali³

et al. 2022

J Med Cases

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QT prolongation is present in 26-52% of cases of Takotsubo cardiomyopathy (TCM). It has been postulated to result from reduced cardiac repolarization reserve and reflects the transient myocardial insult observed in TCM. Bradycardia-induced QT interval prolongation is amplified by the occurrence of TCM, a combination that potentially carries a significant risk for torsade de pointes (TdP). We present a unique case of an 80-year-old female with TCM-related cardiac arrest. The patient had acquired long QT syndrome in which TCM myocardial insult led to the precipitation of a third-degree atrioventricular (AV) block and subsequent bradycardia-induced TdP. Due to the lack of robust literature, there is no clear guideline in the management of third-degree AV block in the setting of TCM. In our case, because of recurrent ventricular tachycardia (VT) and ventricular fibrillation (VF) arrest, we opted for temporary pacing at a high ventricular rate, followed by a biventricular implantable cardioverter-defibrillator (BiV/ICD). Follow-up 3 months later revealed improvement of left ventricular (LV) dysfunction and resolution of QT prolongation. However, the noticed AV conduction defects persisted. In the available literature, we identified five reported cases that bear similarity with our patient's presentation. The identified cases were middle-aged to elderly females with no significant cardiac history, who exhibited a similar triad of TCM associated with high-grade AV block, acquired long QT syndrome, and a rapid progression of bradycardia-induced TdP, resulting in a near cardiac arrest within the first 24 -48 h of admission. It is crucial to monitor corrected QT (QTc), correct electrolyte abnormalities, and minimize QT-prolonging medications in patients with TCM. The recognition of AV conduction defects in patients with TCM is critical, especially if it is associated with significant QT prolongation. Such situations are underrecognized, and are potentially fatal, necessitating close monitoring and timely intervention.

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Permanent Pacemaker Implantation in a Patient with Takotsubo Cardiomyopathy and Complete Atrioventricular Block

Cited by 5 publications

References 16 publications

Complete Heart Block Causing Takotsubo Syndrome: A Case Report

Complete Heart Block Causing Takotsubo Syndrome: A Case Report

The Fatal Interplay between Stress Induced Cardiomyopathy, Arrhythmia and Cardiogenic Shock

The Ominous Triad of Severe Takotsubo Cardiomyopathy

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