Ventricular arrhythmias in Takotsubo Syndrome: incidence, predictors and clinical outcomes.

To investigate predictors of the occurrence of subacute ventricular arrhythmias (VAs), defined as any VAs presenting after 48 h from admission in patients with Takotsubo Syndrome (TTS), and to evaluate the related in-hospital mortality. This is a retrospective single-center study enrolling patients admitted between 2012 and 2017 with TTS according to International Takotsubo diagnostic criteria. Data collection included ECG on admission and at 48 h, telemetry monitoring and transthoracic echocardiogram. We enrolled 93 patients; during in-hospital stay (mean 14 ± 16 days) subacute VAs occurred in 25% of patients (VAs group). Life-threatening VAs occurred in 6% of patients (3 sustained ventricular tachycardia, 1 torsade de pointes, 1 ventricular fibrillation) and not life-threatening VAs in 19% (6 non-sustained ventricular tachycardia and 12 premature ventricular contractions > 2000 in 24 h). Mortality was higher in the VAs than in the non-VAs group (P = 0.03), without differences in terms of life-threatening and not life-threatening subacute VAs (P = 0.65) and VAs on admission (P = 0.25). Logistic regression identified the following independent predictors of subacute VAs occurrence: VAs on admission {odds ratio [OR] 22.5 (3.9-131.8), P = 0.001]}, New York Heart Association (NYHA) class III-IV on admission [OR 6.7 (1.3- 34.0), P = 0.021] and QTc at 48 h [OR 1.01 (1.00-1.03), P = 0.046]. TTS patients with VAs and NYHA class III-IV on admission and higher QTc at 48 h are at increased risk of subacute VAs occurrence, associated with higher in-hospital mortality. Awareness of this potential complication is critical for proper patients management. Copyright © 2020 Italian Federation of Cardiology - I.F.C. All rights reserved.

Citation

Gemma Pelargonio, Giulio La Rosa, Enrico Di Stasio, Maria Lucia Narducci, Erica Rocco, Alessio Angelini, Gaetano Pinnacchio, Gianluigi Bencardino, Francesco Perna, Gianluca Comerci, Fiammetta Catania, Filippo Crea. Ventricular arrhythmias in Takotsubo Syndrome: incidence, predictors and clinical outcomes. Journal of cardiovascular medicine (Hagerstown, Md.). 2021 Mar 01;22(3):180-189

Mesh Tags

PMID: 32890232

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