Key result
A 66-year-old female with Takotsubo cardiomyopathy and supra-Hisian AV block required a pacemaker at 2 weeks but showed complete recovery of AV conduction and ventricular function at 1 month.
Case Report (n=1)
Delayed recovery of AV conduction is possible in Takotsubo cardiomyopathy, suggesting a longer observation period may be warranted before permanent pacemaker implantation.
May warrant extended observation before permanent pacing in Takotsubo with AV block; leaves open optimal timing in larger cohorts.
BACKGROUND: Atrioventricular (AV) block is rare in Takotsubo cardiomyopathy (TC). CASE REPORT: A 66-year-old female presented with fatigue. Her electrocardiogram revealed 3:2 Mobitz Type II AV block, confirmed to be supra-Hisian by electrophysiological study. Echocardiogram and left ventricular angiogram showed moderate left ventricular dysfunction and apical ballooning, whereas coronary angiogram revealed mildly ectatic coronaries. At 2 weeks AV block persisted, needing permanent pacemaker implantation. At 1-month follow-up, she had normal ventricular function and no AV block. CONCLUSION: Delayed recovery of AV conduction is possible in TC, thus implying to wait for a longer period before implanting a pacemaker.
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Prabhu et al. (2016) conducted a case report in Takotsubo cardiomyopathy with atrioventricular block (n=1). Permanent pacemaker implantation was evaluated on Recovery of AV conduction and ventricular function. A 66-year-old female with Takotsubo cardiomyopathy and supra-Hisian AV block required a pacemaker at 2 weeks but showed complete recovery of AV conduction and ventricular function at 1 month.
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