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Review
. 2024 Aug;10(8):1943-1952.
doi: 10.1016/j.jacep.2024.03.034. Epub 2024 Jun 5.

Life-Threatening Arrhythmias in Patients With Takotsubo Syndrome: Insights Into Pathophysiology and Treatment Innovations

Giulia La Vecchia  1 , Marco Giuseppe Del Buono  2 , Tommaso Sanna  2 , Pier Leopoldo Capecchi  3 , Pietro Enea Lazzerini  3 , Michele Golino  4 , Jordana Kron  5 , Paula Rodriguez-Miguelez  6 , Gemma Pelargonio  2 , Antonio Abbate  7
Affiliations
Free article
Review

Life-Threatening Arrhythmias in Patients With Takotsubo Syndrome: Insights Into Pathophysiology and Treatment Innovations

Giulia La Vecchia et al. JACC Clin Electrophysiol. 2024 Aug.
Free article

Abstract

Takotsubo syndrome (TTS) is a reversible form of acute myocardial injury due to a neurocardiogenic mechanism associated with a relevant risk for life-threatening ventricular arrhythmias, occurring in up to 25% of all patients and including both ventricular arrhythmias (especially) in the context of QT prolongation and atrial tachy- or bradyarrhythmias. The pathogenetic mechanisms of TTS-related arrhythmic complications are not completely understood, and there are no randomized clinical trials addressing the pharmacologic and nonpharmacologic management in this specific setting. In this narrative review, the authors provide an overview of the pathogenesis and the therapeutic management of arrhythmic complications in patients with TTS, along with the future perspectives and the remaining knowledge gaps in this field.

Keywords: QT prolongation; arrhythmias; autonomic modulation; stress cardiomyopathy.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Abbate has received consulting fees from Cardiol, Implicit Biosciences, Novo Nordisk, Kiniksa, Olatec, and Serpin Pharma. Dr Sanna is a consultant for Medtronic. Dr Lazzerini has received a grant from Roche Italia outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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