Title

Acquired long QT syndrome from stress cardiomyopathy is associated with ventricular arrhythmias and torsades de pointes

Authors

Christopher Madias, Rush University Medical Center
Timothy P. Fitzgibbons, University of Massachusetts Medical SchoolFollow
Alawi A. Alsheikh-Ali, Sheikh Khalifa Medical City
Joseph L. Bouchard, University of Massachusetts Medical School
Benjamin Kalsmith, Tufts Medical Center
Ann C. Garlitski, Tufts Medical Center
Dennis A. Tighe, University of Massachusetts Medical SchoolFollow
N. A. Mark Estes III, Tufts Medical Center
Gerard P. Aurigemma, University of Massachusetts Medical SchoolFollow
Mark S. Link, Tufts Medical Center

Student Author(s)

Timothy Fitzgibbons

Academic Program

Interdisciplinary Graduate Program

UMMS Affiliation

Department of Cardiology; Department of Medicine, Division of Cardiovascular Medicine

Publication Date

2011-4

Document Type

Article

Disciplines

Cardiology | Cardiovascular Diseases

Abstract

BACKGROUND: Stress cardiomyopathy (SCM) is a syndrome of transient ventricular dysfunction triggered by severe emotional or physical stress, likely resulting from catecholamine-mediated myocardial toxicity. Repolarization abnormalities associated with other hyperadrenergic states can cause QT prolongation and lethal arrhythmia including torsades de pointes (TdP). Despite the development of repolarization abnormalities and QT prolongation in SCM, little is known about the risk of ventricular fibrillation (VF) and TdP.

OBJECTIVE: The aim of this study was to assess the prevalence and clinical predictors of ventricular arrhythmias in a cohort of patients with SCM.

METHODS: Data from a registry of consecutive patients with SCM from 2 institutions were reviewed. Patients who developed VF or TdP were identified. Clinical characteristics and outcomes were analyzed and compared with a control group of patients with SCM without VF/TdP.

RESULTS: Of 93 patients with SCM, 8 (8.6%) experienced VF/TdP. Of these 8 patients, 2 presented with VF and were subsequently diagnosed with SCM. Six other patients experienced pause-dependent TdP or VF after SCM diagnosis in the setting of substantial QT prolongation. Prolongation of the corrected QT interval (QTc) was significantly associated with the occurrence of ventricular arrhythmia (odds ratio 1.28 for each 10 ms increase in QTc, 95% confidence interval 1.10 to 1.50).

CONCLUSION: SCM can be associated with life-threatening ventricular arrhythmia in over 8% of cases. SCM should be recognized among the causes of acquired long QT syndrome and can be associated with a risk of TdP. reserved.

DOI of Published Version

10.1016/j.hrthm.2010.12.012

Source

Dec 10. Link to article on publisher's site

Journal/Book/Conference Title

Heart rhythm : the official journal of the Heart Rhythm Society

Related Resources

Link to Article in PubMed

PubMed ID

21146632

Repository Citation

Madias C, Fitzgibbons TP, Alsheikh-Ali AA, Bouchard JL, Kalsmith B, Garlitski AC, Tighe DA, Estes N, Aurigemma GP, Link MS. (2011). Acquired long QT syndrome from stress cardiomyopathy is associated with ventricular arrhythmias and torsades de pointes. Morningside Graduate School of Biomedical Sciences Student Publications. https://doi.org/10.1016/j.hrthm.2010.12.012. Retrieved from https://escholarship.umassmed.edu/gsbs_sp/1810