Supra‐Hisian Conduction Block as an Unusual Presenting Feature of Takotsubo Cardiomyopathy

Background Atrioventricular (AV) block is rare in Takotsubo cardiomyopathy (TC). Case report A 66‐year‐old female presented with fatigue. Her electrocardiogram revealed 3:2 Mobitz Type II AV block, confirmed to be supra‐Hisian by electrophysiological study. Echocardiogram and left ventricular angiog...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 2017-05, Vol.40 (5), p.596-599
Main Authors: PRABHU, MUKUND ARAVIND, PAI, PRAVEEN GOPALAKRISHNA, VUPPUTURI, ANJITH, SHEKHAR, SARITHA, HARIKRISHNAN, MADHAVANKUTTY SANTHAKUMARI, KUMARASWAMY, NATARAJAN UMAYAMMAL
Format: Article
Language:English
Subjects:
Aged
AV block
Balloon treatment
Bundle-Branch Block - diagnosis
Bundle-Branch Block - etiology
Cardiac arrhythmia
Cardiomyopathy
Diagnosis, Differential
Echocardiography
EKG
Electrocardiography
Electrocardiography - methods
Electrophysiological recording
Fatigue
Female
Heart
Humans
Rare Diseases - diagnosis
Rare Diseases - etiology
supra‐Hisian
Takotsubo cardiomyopathy
Takotsubo Cardiomyopathy - complications
Takotsubo Cardiomyopathy - diagnosis
Ventricle
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Summary:Background Atrioventricular (AV) block is rare in Takotsubo cardiomyopathy (TC). Case report A 66‐year‐old female presented with fatigue. Her electrocardiogram revealed 3:2 Mobitz Type II AV block, confirmed to be supra‐Hisian by electrophysiological study. Echocardiogram and left ventricular angiogram showed moderate left ventricular dysfunction and apical ballooning, whereas coronary angiogram revealed mildly ectatic coronaries. At 2 weeks AV block persisted, needing permanent pacemaker implantation. At 1‐month follow‐up, she had normal ventricular function and no AV block. Conclusion Delayed recovery of AV conduction is possible in TC, thus implying to wait for a longer period before implanting a pacemaker.
ISSN:0147-8389
1540-8159
DOI:10.1111/pace.12999