Complete His-ventricular block, atrial flutter and ventricular tachycardia as arrhythmogenic activities in a patient with takotsubo cardiomyopathy

Watanabe, Keita; Noda, Makoto; Murakami, Tasuku; Nakamura, Taichi; Hori, Mariko; Kato, Yoko; Setoguchi, Masahiko; Yamamoto, Yoh; Ichikawa, Kenichiro; Usui, Michio; Hariya, Akifusa; Egi, Koso; Takazawa, Kenji; Isobe, Mitsuaki

doi:10.1016/j.jccase.2014.07.012

Cited by 1 publication

(3 citation statements)

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“…They observed that the QTc showed increased values from day one to day three, and patients who developed TdP had slower heart rates [ 24 ]. We also identified this in some of the presented case reports [ 13 , 14 , 18 ]. The latter finding could indicate a direct relationship between abnormal depolarization and the genesis of VA. Song et al studied 105 patients diagnosed with TTC who presented with or without QT prolongation.…”

Section: Reviewmentioning

confidence: 74%

“…ECG showed TdP-type VT, which was terminated by cardio-pulmonary resuscitation without defibrillation. QTc was 693 ms during the episode, and six months after discharge, it returned to the standard value [ 18 ]. Rotondi et al studied a 65-year-old woman with syncope after emotional stress [ 19 ].…”

Section: Reviewmentioning

confidence: 99%

“…TTC tends to occur more frequently in postmenopausal women, especially after a recent stressful episode [ 11 , 13 , 16 , 19 ]; however, younger women are also at risk [ 14 , 17 , 21 ], and incidence in men continues to increase every day [ 18 , 20 ]. Emotional stress is arguably the most common trigger.…”

Section: Reviewmentioning

confidence: 99%

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Pathogenesis of Ventricular Arrhythmias and Its Effect on Long-Term Prognosis in Patients With Takotsubo Cardiomyopathy

Escobar

Myat

Amin

et al. 2020

Cureus

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Takotsubo cardiomyopathy (TTC), also known as broken heart syndrome, stress cardiomyopathy (SCM), or apical ballooning syndrome, is a non-ischemic cardiac disease with an initial clinical presentation that is very similar to acute coronary syndrome (ACS). Ventricular arrhythmias (VAs) contribute significantly to an increase in the rates of death in patients with TTC, especially during the acute phase, in which patients with TTC are more susceptible to develop life-threatening arrhythmias (LTA) such as ventricular tachycardia (VT), ventricular fibrillation (VF), torsades de pointes (TdP), and sudden cardiac death (SCD). However, the pathophysiology of TTC and how VA occurs are still a mystery. We aim to review previous literature and discuss the possible mechanisms of VA in TTC patients. VA usually complicates the acute phase of the disease and worsens the long-term prognosis. Alterations of repolarization (negative T wave, prolonged QTc) indicate a high risk of arrhythmic events (TdP, VT, VF, and SCD). Catecholamine effect on myocardial cells and myocardial edema can create a substrate for the development of VA. Some of the most commonly proposed mechanisms for the development of VA in patients with TTC are coronary vasospasm, myocardial stunning due to catecholamines, re-entry, and triggered activity. Further prospective studies, including a more significant number of patients, are required to understand the disease's pathophysiology better and improve LTA management in patients with TTC.

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