Key result
Ventricular arrhythmias in Takotsubo syndrome contribute significantly to mortality, prompting a review of therapeutic strategies including the use of implantable cardioverter-defibrillators.
This review summarizes the mechanisms, prognosis, and management of ventricular arrhythmias in Takotsubo syndrome, including the controversial role of implantable cardioverter-defibrillators.
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Arrhythmia vigilance may aid Takotsubo management; leaves open ICD indications without prospective trials.
Takotsubo syndrome (TTS) is a unique nonischemic cardiac disease characterized by acute myocardial dysfunction of the left and/or right ventricle. Patients are predominantly postmenopausal women and usually present with symptoms indistinguishable from acute coronary syndrome. Although the exact pathomechanisms of TTS remain elusive, increasing evidence suggests that sympathetic overdrive and catecholamine excess might play a central role. Despite the complete recovery of ventricular dysfunction within several days to weeks, patients with TTS exhibit considerable short- and long-term mortality rates and ventricular arrhythmias have been identified as key contributor to morbidity and mortality. This article summarizes the prevalence, underlying mechanisms, therapeutic strategies, and prognostic implications of ventricular arrhythmias in TTS. Furthermore, the need for implantable cardioverter-defibrillators is discussed in view of the transient character of the disease.
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Möller et al. (2018) conducted a review in Takotsubo syndrome. Ventricular arrhythmias in Takotsubo syndrome contribute significantly to mortality, prompting a review of therapeutic strategies including the use of implantable cardioverter-defibrillators.
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