Ventricular arrhythmias and sudden cardiac arrest in Takotsubo cardiomyopathy: Incidence, predictive factors, and clinical implications

AbstractA 9-year-old African-American girl presented with sudden cardiac arrest a few hours after adenotonsillectomy. She received anaesthesia which included propofol during the procedure. Her electrocardiogram (EKG) showed type 1 Brugada pattern, and genetic testing revealed a variant of unknown significance in desmoplakin (DSP) gene. We discuss the association between propofol, Brugada EKG pattern, and malignant ventricular arrhythmias.

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Arrhythmogenic nitro-oxidative Stress: a proposed in mechanism underlying ventricular arrhythmias that may cause sudden cardiac arrest in Chagas’ heart disease

Free Radical Biology and Medicine ◽

10.1016/j.freeradbiomed.2018.04.294 ◽

2018 ◽

Vol 120 ◽

pp. S89

Author(s):

Roberto Coury Pedrosa ◽

Danilo Wilhelm Filho ◽

Rozangela Curi Pedrosa

Keyword(s):

Oxidative Stress ◽

Cardiac Arrest ◽

Heart Disease ◽

Ventricular Arrhythmias ◽

Sudden Cardiac Arrest ◽

Chagas Heart Disease

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Usefulness of cardiac magnetic resonance images for prediction of sudden cardiac arrest in patients with mitral valve prolapse: a multicenter retrospective cohort study

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02362-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jae-Hyuk Lee ◽

Jae-Sun Uhm ◽

Young Joo Suh ◽

Min Kim ◽

In-Soo Kim ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Mitral Valve ◽

Predictive Factors ◽

Mitral Valve Prolapse ◽

Sudden Cardiac Arrest ◽

Systolic Pressure ◽

Magnetic Resonance Images ◽

Volume Index

Abstract Background An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate predictive factors for SCA or VA in MVP patients. Methods MVP patients who underwent cardiac magnetic resonance (CMR) were retrospectively included. Patients with other structural heart disease or causes of aborted SCA were excluded. Clinical characteristics (sex, age, body mass index, histories of diabetes, hypertension, and dyslipidemia) and electrocardiographic (PR interval, QRS duration, corrected QT interval, inverted T wave in the inferior leads, bundle branch block, and atrial fibrillation), echocardiographic [mitral regurgitation grade, prolapsing mitral leaflet, and right ventricular systolic pressure (RVSP)], and CMR [left atrial volume index, both ventricular ejection fractions, both ventricular end-diastolic and systolic volume indexes, prolapse distance, mitral annular disjunction, systolic curling motion, presence of late gadolinium enhancement (LGE), LGE volume and proportion] parameters were analyzed. Results Of the 85 patients [age, 54.0 (41.0–65.0) years; 46 men], seven experienced SCA or VA. Younger age and wide QRS complex were observed more often in the SCA/VA group than in the no-SCA/VA group. The SCA/VA group exhibited lower RVSP, more systolic curling motion and LGE, greater LGE volume, and higher LGE proportion. The presence of LGE [hazard ratio (HR), 19.8; 95% confidence interval (CI) 2.65–148.15; P = 0.004], LGE volume (HR 1.08; 95% CI 1.02–1.14; P = 0.006) and LGE proportion (HR 1.32; 95% CI 1.08–1.60; P = 0.006) were independently associated with higher risk of SCA or VA in MVP patients together with systolic curling motion in each model. Conclusions The presence of systolic curling motion, high LGE volume and proportion, and the presence of LGE on CMR were independent predictive factors for SCA or VA in MVP patients.

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Sudden cardiac arrest and ventricular arrhythmias following first type I myocardial infarction in the contemporary era

Journal of Cardiovascular Electrophysiology ◽

10.1111/jce.14218 ◽

2019 ◽

Vol 30 (12) ◽

pp. 2869-2876 ◽

Cited By ~ 2

Author(s):

Mustapha Amin ◽

Danesh Kella ◽

Ammar M. Killu ◽

Deepak Padmanabhan ◽

David O. Hodge ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiac Arrest ◽

Ventricular Arrhythmias ◽

Sudden Cardiac Arrest ◽

Type I

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Alcohol Use Disorder is Associated with an Increased Risk for Respiratory Failure among Patients with Takotsubo Cardiomyopathy

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4166 ◽

2020 ◽

Vol 8 (B) ◽

pp. 268-272

Author(s):

Temidayo Abe ◽

Valery Effoe ◽

Dolphurs Hayes ◽

Obiora Egbuche ◽

Huynh Ky ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiac Arrest ◽

Respiratory Failure ◽

Alcohol Abuse ◽

Cardiogenic Shock ◽

Acute Respiratory Failure ◽

Takotsubo Cardiomyopathy ◽

Alcohol Use Disorder ◽

Sudden Cardiac Arrest ◽

Increased Risk

BACKGROUND: While takotsubo cardiomyopathy (TCM) was initially considered a benign disease, recent studies have demonstrated poor cardiovascular outcomes. It is important to determine the predictors of these outcomes for appropriate risk stratification and to decrease the overall disease burden. Physical stressors (e.g., acute neurologic disorder and lung disorder) and pre-existing heart failure have been associated with worse outcomes. Alcohol abuse has been associated with cardiomyopathy and may also exacerbate pre-existing heart conditions. AIM: We aimed to determine the impact of alcohol abuse on patients with TCM. METHODS: We identified 11,221 patients from the 2009 to 2012 National Inpatient Sample, of which 10,622 had TCM alone and 599 had TCM and alcohol use disorder (AUD). Our outcomes of interest were overall mortality, need for mechanical hemodynamic support (MHS), acute respiratory failure, sudden cardiac arrest, cardiogenic shock, stroke, and atrial fibrillation. All clinical characteristics were defined per the International Classification of Diseases 9th revision codes. Logistic regression was used to estimate the odds ratios of the outcomes in patients with concomitant TCM and AUD, compared to those with TCM without AUD while adjusting for confounders. RESULTS: The mean age of the sample was 60.5 ± 11 for TCM with AUD and 56.0 ± 11 for TCM alone. There was no significant difference between the two groups in the rates of atrial fibrillation (10.4% vs. 8,5%; p = 0.134), cardiogenic shock (5.9% vs. 4.8%; p = 0.3), use of MHS (2.6% vs. 1.7%; p = 0.165), overall in-hospital mortality (4.0% vs. 3.7%; p = 0.691), stroke (1.6% vs. 1.3%; p = 0.593), and sudden cardiac arrest (2.7% vs. 3.5%; p = 0.24). Rates of acute respiratory failure (17.7% vs. 25.2%; p < 0.0001) were significantly higher in patients with TCM with AUD compared to those with TCM alone. After adjusting for significant cofounders, the odds ratio for respiratory failure among patients with concomitant TCM and AUD was 1.36 (95% CI: 1.11–1.66) compared to those with TCM without AUD. CONCLUSION: Pre-existing AUD is associated with an increased risk for respiratory failure in a patient with TCM.

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