Delayed ventricular pacing failure and correlations between pacing thresholds, left ventricular ejection fraction, and QTc values in a male with Takotsubo cardiomyopathy

Background Transient pacing failure caused by transient increased pacing threshold has been reported in patients with transient left ventricular apical dysfunction (Takotsubo cardiomyopathy [TC]). Normal pacing thresholds usually recover after normalization of systolic dysfunction. Hypothesis Pacing...

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Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2018-11, Vol.41 (11), p.1487-1490
Main Authors: Brunetti, Natale D., D'Arienzo, Girolamo, Sai, Rafel, Pellegrino, Pier L., Ziccardi, Luigi, Santoro, Francesco, Di Biase, Matteo
Format: Article
Language:English
Subjects:
Action Potentials
Aged
Atrial Fibrillation - diagnosis
Atrial Fibrillation - physiopathology
Atrial Fibrillation - therapy
Beta blockers
Cardiac Pacing, Artificial - methods
Cardiomyopathy
Clinical Investigations
Edema
Ejection fraction
Electrocardiography
Heart Rate
Humans
Male
male gender
myocardial edema
pacing failure
Sick Sinus Syndrome - diagnosis
Sick Sinus Syndrome - physiopathology
Sick Sinus Syndrome - therapy
Stroke Volume
Takotsubo cardiomyopathy
Takotsubo Cardiomyopathy - diagnosis
Takotsubo Cardiomyopathy - physiopathology
Time Factors
Treatment Failure
Ventricular Function, Left
Ventricular Function, Right
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Summary:Background Transient pacing failure caused by transient increased pacing threshold has been reported in patients with transient left ventricular apical dysfunction (Takotsubo cardiomyopathy [TC]). Normal pacing thresholds usually recover after normalization of systolic dysfunction. Hypothesis Pacing failure correlates with clinics of TC. Methods We report the case of a 76‐year‐old man with a dual chamber pacemaker, admitted for acute chest pain and dyspnea and final diagnosis of TC. One month after index admission, the patient came back complaining again of chest pain. Unexpectedly, admission electrocardiogram showed ventricular pacing failure and an increased pacing threshold. In the following weeks, pacing threshold gradually recovered with left ventricular ejection fraction and QTc values. Results Ventricular pacing threshold correlated directly to QTc values and inversely to left ventricular ejection fraction over time (P 
ISSN:0160-9289
1932-8737
DOI:10.1002/clc.23082