Key result
Complete AV block in takotsubo cardiomyopathy persists despite LV recovery, requiring a permanent pacemaker.
Why the study?
Complete atrioventricular block associated with takotsubo cardiomyopathy may persist after improvement of left ventricular wall motion, requiring further management.
Case Report (n=1)
No
Complete AV block associated with Takotsubo cardiomyopathy may persist even after recovery of left ventricular function, necessitating permanent pacemaker implantation.
Persistent AV block in takotsubo may require permanent pacing despite LV recovery; leaves open incidence, predictors, and management in larger cohorts.
An 82-year-old woman was admitted to the hospital due to repeated episodes of syncope with incontinence. Electrocardiography showed torsades de pointes, complete atrioventricular (AV) block, T-wave inversions and a prolonged QTc interval. Urgent coronary angiography showed no significant coronary stenosis and left ventriculography demonstrated typical abnormal wall motion of takotusbo cardiomyopathy. Electrophysiology study suggested that the damaged structure might be the bundle of His. After temporary transvenous pacing and administration of intravenous lidocaine, no recurrence of torsade de pointes was found. Symptoms of worsening heart failure were not found. Although abnormal left ventricular wall motion improved, a complete AV block remained and the patient needed pacemaker implantation on Day 18 after admission. This case demonstrated that complete AV block associated with takotsubo cardiomyopathy may persist after improvement of left ventricular wall motion, and implantation of a pacemaker may be needed.
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Inoue et al. (2009) conducted a case report in Takotsubo cardiomyopathy with complete atrioventricular block (n=1). Pacemaker implantation was evaluated on Clinical recovery and resolution of AV block. Complete atrioventricular block associated with takotsubo cardiomyopathy persisted despite improvement of left ventricular wall motion, requiring permanent pacemaker implantation.
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