Malignant arrhythmia in apical ballooning syndrome: Risk factors and outcomes

Chadi Dib, Abhiram Prasad, Paul Andrew Friedman, Ahmad Elesber, Charanjit S. Rihal, Stephen C. Hammill, Samuel J Asirvatham

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objectives: We sought to determine the frequency and outcomes with symptomatic arrhythmia in patients with apical ballooning syndrome (ABS). Methods: A retrospective review of the Mayo Clinic Angiography database was conducted to identify patients who met the Mayo criteria for ABS. Patients with documented arrhythmias formed the study group, and 31 randomly selected patients with ABS but without arrhythmia formed the control group Results: Out of 105 patients identified with ABS, 6 (5.7%) women aged 69 +/- 9 years experienced significant arrhythmia (ventricular fibrillation, asystole), 2 patients died, and 1 required permanent pacemaker implantation. When compared with controls, the study group showed no significant difference with respect to ECG characteristics (QT, QRS duration or axis) except for R-R interval variability (see comments below) (30.6±6 vs 14.5±17 p = 0.0004), QTc, and P-R interval. Patients without arrhythmia were more likely to be on beta-blocker therapy than the study population (33% vs 80.6% p = 0.02). Conclusion: Life-threatening arrhythmia is uncommon (5.7%) with ABS despite marked, structural abnormalities. When arrhythmias do occur, the outcome is poor. Prominent variability in R-R intervals appears to be predictive of significant arrhythmias in ABS. The role of beta-blocker therapy in preventing arrhythmia with ABS requires further investigation.

Original languageEnglish (US)
Pages (from-to)182-192
Number of pages11
JournalIndian Pacing and Electrophysiology Journal
Volume8
Issue number3
StatePublished - Jul 2008

Fingerprint

Takotsubo Cardiomyopathy
Cardiac Arrhythmias
Control Groups
Ventricular Fibrillation
Heart Arrest
Angiography
Electrocardiography
Databases

Keywords

  • Apical ballooning
  • Arrhythmia
  • Atrioventricular block
  • Sudden death
  • Takotsubo cardiomyopathy
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Malignant arrhythmia in apical ballooning syndrome : Risk factors and outcomes. / Dib, Chadi; Prasad, Abhiram; Friedman, Paul Andrew; Elesber, Ahmad; Rihal, Charanjit S.; Hammill, Stephen C.; Asirvatham, Samuel J.

In: Indian Pacing and Electrophysiology Journal, Vol. 8, No. 3, 07.2008, p. 182-192.

Research output: Contribution to journalArticle

Dib, Chadi ; Prasad, Abhiram ; Friedman, Paul Andrew ; Elesber, Ahmad ; Rihal, Charanjit S. ; Hammill, Stephen C. ; Asirvatham, Samuel J. / Malignant arrhythmia in apical ballooning syndrome : Risk factors and outcomes. In: Indian Pacing and Electrophysiology Journal. 2008 ; Vol. 8, No. 3. pp. 182-192.
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abstract = "Objectives: We sought to determine the frequency and outcomes with symptomatic arrhythmia in patients with apical ballooning syndrome (ABS). Methods: A retrospective review of the Mayo Clinic Angiography database was conducted to identify patients who met the Mayo criteria for ABS. Patients with documented arrhythmias formed the study group, and 31 randomly selected patients with ABS but without arrhythmia formed the control group Results: Out of 105 patients identified with ABS, 6 (5.7{\%}) women aged 69 +/- 9 years experienced significant arrhythmia (ventricular fibrillation, asystole), 2 patients died, and 1 required permanent pacemaker implantation. When compared with controls, the study group showed no significant difference with respect to ECG characteristics (QT, QRS duration or axis) except for R-R interval variability (see comments below) (30.6±6 vs 14.5±17 p = 0.0004), QTc, and P-R interval. Patients without arrhythmia were more likely to be on beta-blocker therapy than the study population (33{\%} vs 80.6{\%} p = 0.02). Conclusion: Life-threatening arrhythmia is uncommon (5.7{\%}) with ABS despite marked, structural abnormalities. When arrhythmias do occur, the outcome is poor. Prominent variability in R-R intervals appears to be predictive of significant arrhythmias in ABS. The role of beta-blocker therapy in preventing arrhythmia with ABS requires further investigation.",
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