Key result
High-degree AV block in Takotsubo cardiomyopathy resolves spontaneously without permanent pacemaker implantation.
Why the study?
The coexistence of Takotsubo cardiomyopathy with transient high-degree AV block is very infrequent and presents a clinical management challenge.
Case Report (n=1)
Transient high-degree AV block in Takotsubo may resolve spontaneously without pacing; leaves open whether this approach is safe in broader populations.
BACKGROUND: Takotsubo cardiomyopathy is a non-ischemic cardiomyopathy characterized by acute left ventricular systolic dysfunction with transient wall motion abnormalities without a culprit coronary stenosis or other concurrent diagnoses. Its coexistence with transient high-degree AV block is very infrequent. CASE PRESENTATION: A 61-year-old man presented with a new onset of high degree AV block without ST segment deviations developing an anterior and apical dyskinesia with a low left ventricular ejection fraction in the absence of coronary artery disease. CONCLUSION: Atrioventricular block is an uncommon presentation of Takotsubo syndrome. The management of patients with relevant conduction disorders in this scenario is a challenge for the clinician. In case of persistence of advanced conduction disorders, it seems appropriate to implant a pacemaker.
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Revilla-Martí et al. (2021) conducted a case report in Takotsubo cardiomyopathy and high-degree atrioventricular block (n=1). Takotsubo cardiomyopathy with high-degree AV block was evaluated. A 61-year-old man presenting with Takotsubo cardiomyopathy and rare high-degree atrioventricular block experienced rapid spontaneous recovery of normal AV conduction without pacemaker implantation.
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