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Background: Takotsubo cardiomyopathy (TCM), although generally considered reversible, can be associated with significant mortality due to lethal arrhythmias. Repolarization abnormalities in TCM can lead to characteristic T-wave abnormalities & QT prolongation that place patients at increased risk for ventricular arrhythmias. We evaluated the prevalence of various arrhythmias associated with TCM.
Methods: Electronic-health-records (Jan 2000 to Dec 2015) from 13 different healthcare systems were obtained utilizing a HIPAA-compliant, patient de-identified web application (Explore; Explorys Inc) and reviewed.
Results: Out of 4,513 patients with TCM (of which 2,661 were > 65 years, 59%), 21.6 % were smokers, 28.4 % had Hypertension, 26.6 % had Diabetes, 39.5 % had peripheral vascular disease. We found a significant prevalence of ventricular fibrillation (n = 84; 1.9%), ventricular tachycardia (n = 312; 6.9 %). Atrial fibrillation, atrial flutter and other supraventricular tachycardias were collectively around 29.2 % (n= 1,316). All-cause mortality was 3.3 % (n= 151).
Conclusions: We found a significant prevalence of life-threatening arrhythmias in TCM. The need for implantable cardiac-defibrillators is a matter of debate given the reversible nature of TCM, but these patients will need to be monitored closely and after risk stratification, may benefit from wearable cardiac defibrillators until ventricular function improves.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in HCM, PPCM and Other Cardiomyopathies
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1201-289
- 2017 American College of Cardiology Foundation