Takotsubo cardiomyopathy and QT interval prolongation: who are the patients at risk for torsades de pointes?

Is abnormal myocardial repolarization associated with the occurrence of malignant tachyarrhythmias in Takotsubo cardiomyopathy?

“…This was also true for the subset of patients with TdP in whom one would intuitively expect particularly long QTc intervals. Our findings concur with observations made by Samuelov-Kinori et al [22]. In their recently published study, the authors compared 15 patients with TC-associated TdP from published reports with 86 patients from published reports who had TC-associated QT interval prolongation without TdP.…”

The QT prolongation and clinical features in patients with takotsubo cardiomyopathy: Experiences of two tertiary cardiovascular centers

“…Frequent ECG changes in TTC include ST segment elevation, T wave inversion, and prolongation of QT interval, the latter often being quite pronounced (1)(2)(3)(4). It is becoming evident that TTC should be considered among the causes of acquired QT prolongation (7,8). QT prolongation is associated with sudden cardiac death as a result of reentrant polymorphic VT, torsades de pointes (TDP), which can degenerate into VF (5, 16).…”

“…QT prolongation is associated with sudden cardiac death as a result of reentrant polymorphic VT, torsades de pointes (TDP), which can degenerate into VF (5, 16). More recently, VF had been previously described in the clinical presentation of TTC (2,8,17). However, despite these severe repolarization abnormalities seen in TTC, the pathophysiology of life-threatening arrhythmias in TTC remains incompletely understood, and the clinical features remain uncertain.…”

“…Although the association between TTC and QT prolongation has been reported (4)(5)(6)(7)(8), there are few data regarding the clinical characteristics in TTC patients presenting with QT prolongation in detail. Moreover, there remains very little emphasis on arrhythmic risk in contemporary reviews despite the increasing numbers of life-threatening arrhythmias reported in the setting of TTC with QT prolongation (5).…”

Torsades de Pointes in Takotsubo Cardiomyopathy with QT Prolongation

“…On the other hands, TdP may be one of the trigger of Takotsubo cardiomyopathy in long QT syndrome. Although it occurs most frequently in women over 50 years of age, recent study demonstrated that men with Takotsubo cardiomyopathy-associated QT interval prolongation are at risk for TdP, and that most patients with Takotsubo cardiomyopathyassociated TdP have risk factors for TdP other than the female sex and systolic dysfunction (Samuelov-Kinori, 2009 …”