Frailty and cognitive impairment are predictive of takotsubo syndrome following pacemaker implantation.
apical ballooning syndrome
pacemaker implantation
takotsubo
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
31
10
2019
revised:
19
03
2020
accepted:
12
04
2020
pubmed:
19
4
2020
medline:
6
10
2021
entrez:
19
4
2020
Statut:
ppublish
Résumé
Pacemaker (PM) implantation may cause acute emotional distress leading to takotsubo syndrome (TTS). Frailty and cognitive impairment are known to influence outcomes after surgical procedures. It is unclear whether they may also predispose to TTS following PM implantation. We identified nine cases (81 ± 6 years) of TTS following PM implantation that took place between 2013 and 2017 in one high volume implantation center. TTS was diagnosed based on typical echocardiographic appearance with resolution over time and (in cases where deemed necessary) normal coronary angiography. The TTS cases were compared with 30 consecutive cases of PM implantation (75 ± 9 years), which were not complicated by TTS (control group). Frailty was assessed using retrospective Risk Analysis Index (RAI-A). Pacing parameters were analyzed during PM implantation and after 1 month. Cognitive impairment was more prevalent (67% vs 10%, P = .0005), and RAI-A index was significantly higher in the TTS group compared to the control group (26 ± 13.7 vs 13.1 ± 9.8, P = .008). Perioperative right ventricular threshold was significantly higher in patients with TTS comparing to controls (0.99 ± 0.43 V vs 0.74 ± 0.20 V, P = .04). The magnitude of decrease in right ventricular threshold between implantation and 1 month follow-up was greater in TTS patients compared to controls (-0.41 ± 0.29 V vs -0.15 ± 0.38 V, P = .049). TTS is a rare complication of PM implantation. Patients with cognitive impairment and frailty are at risk of TTS. Right ventricular pacing threshold is acutely affected by TTS and improves over time.
Sections du résumé
BACKGROUND
Pacemaker (PM) implantation may cause acute emotional distress leading to takotsubo syndrome (TTS). Frailty and cognitive impairment are known to influence outcomes after surgical procedures. It is unclear whether they may also predispose to TTS following PM implantation.
METHODS
We identified nine cases (81 ± 6 years) of TTS following PM implantation that took place between 2013 and 2017 in one high volume implantation center. TTS was diagnosed based on typical echocardiographic appearance with resolution over time and (in cases where deemed necessary) normal coronary angiography. The TTS cases were compared with 30 consecutive cases of PM implantation (75 ± 9 years), which were not complicated by TTS (control group). Frailty was assessed using retrospective Risk Analysis Index (RAI-A). Pacing parameters were analyzed during PM implantation and after 1 month.
RESULTS
Cognitive impairment was more prevalent (67% vs 10%, P = .0005), and RAI-A index was significantly higher in the TTS group compared to the control group (26 ± 13.7 vs 13.1 ± 9.8, P = .008). Perioperative right ventricular threshold was significantly higher in patients with TTS comparing to controls (0.99 ± 0.43 V vs 0.74 ± 0.20 V, P = .04). The magnitude of decrease in right ventricular threshold between implantation and 1 month follow-up was greater in TTS patients compared to controls (-0.41 ± 0.29 V vs -0.15 ± 0.38 V, P = .049).
CONCLUSIONS
TTS is a rare complication of PM implantation. Patients with cognitive impairment and frailty are at risk of TTS. Right ventricular pacing threshold is acutely affected by TTS and improves over time.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
730-736Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Kurisu S, Sato H, Kawagoe T, et al. Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction. Am Heart J. 2002;143:448-455.
Kato K, Lyon AR, Ghadri J-R, Templin C. Takotsubo syndrome: aetiology, presentation and treatment. Heart. 2017;103:1461-1469.
Dawson DK. Acute stress-induced (takotsubo) cardiomyopathy. Heart. 2018;104:96-102.
Redfors B, Vedad R, Angerås O, et al. Mortality in takotsubo syndrome is similar to mortality in myocardial infarction: a report from the SWEDEHEART registry. Int J Cardiol. 2015;185:282-289.
Kosuge M, Ebina T, Hibi K, et al. Simple and accurate electrocardiographic criteria to differentiate takotsubo cardiomyopathy from anterior acute myocardial infarction. J Am Coll Cardiol. 2010;55:2514-2516.
Said SM, Saygili E, Rana OR, et al. Takotsubo cardiomyopathy: what we have learned in the last 25 years? (A comparative literature review). Curr Cardiol Rev. 2016;12:297-303.
Nowak R, Fijalkowska M, Gilis-Malinowska N, et al. Left ventricular function after takotsubo is not fully recovered in long-term follow-up: a speckle tracking echocardiography study. Cardiol J. 2017;24:57-64.
Wittstein IS, Thiemann DR, Lima JAC, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352:539-548.
Martin EA, Prasad A, Rihal CS, Lerman LO, Lerman A. Endothelial function and vascular response to mental stress are impaired in patients with apical ballooning syndrome. J Am Coll Cardiol. 2010;56:1840-1846.
Templin C, Ghadri JR, Diekmann J, et al. Clinical features and outcomes of takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373:929-938.
Mawad W, Guerra PG, Dubuc M, Khairy P. Tako-tsubo cardiomyopathy following transcatheter radiofrequency ablation of the atrioventricular node. Europace. 2007;9:1075-1076.
Dashwood A, Rahman A, Al MarashiH, Jennings C, Raniga M, Dhillon P. Pacemaker-induced takotsubo cardiomyopathy. Heart Case Reports. 2016;2:272-276.
Postema PG, Wiersma JJ, van der Bilt IAC, Dekkers P, van Bergen PFMM. Takotsubo cardiomyopathy shortly following pacemaker implantation-case report and review of the literature. Neth Heart J. 2014;22:456-459.
Golzio PG, Anselmino M, Presutti D, Cerrato E, Bollati M, Gaita F. Takotsubo cardiomyopathy as a complication of pacemaker implantation. J Cardiovasc Med (Hagerstown). 2011;12:754-760.
Hall DE, Arya S, Schmid KK, et al. Association of a frailty screening initiative with postoperative survival at 30, 180, and 365 days. JAMA Surg. 2017;152:233-240.
Bagnall NM, Faiz O, Darzi A, Athanasiou T. What is the utility of preoperative frailty assessment for risk stratification in cardiac surgery? Interact Cardiovasc Thorac Surg. 2013;17:398-402.
Melin AA, Schmid KK, Lynch TG, et al. Preoperative frailty risk analysis index to stratify patients undergoing carotid endarterectomy. J Vasc Surg. 2015;61:683-689.
Gardini A, Fracassi F, Boldi E, Albiero R. Apical Ballooning syndrome (takotsubo cardiomyopathy) after permanent dual-chamber pacemaker implantation. Case Reports Cardiol. 2012;2012:1-3.
Wei Z-H, Dai Q, Wu H, Song J, Wang L, Xu B. Takotsubo cardiomyopathy after pacemaker implantation. J Geriatr Cardiol. 2018;15:246-248.
Dias A, Franco E, Usatii V. Stress-induced cardiomyopathy shortly after pacemaker placement. J Invasive Cardiol. 2013;25:E207-E209.
Mazurek JA, Gundewar S, Ji SY, Grushko M, Krumerman A. Left ventricular apical ballooning syndrome after pacemaker implantation in a male. J Cardiol Cases. 2011;3:e154-e158.
Konstantinos G, El-Battrawy I, Schramm K, et al. Comparison and outcome analysis of patients with takotsubo cardiomyopathy triggered by emotional stress or physical stress. Front Psychol. 2017;8:527.
Xue Q-L. The frailty syndrome: definition and natural history. Clin Geriatr Med. 2011;27:1-15.
Katayama PL, Dias DPM, Silva LEV, Virtuoso-Junior JS, Marocolo M. Cardiac autonomic modulation in non-frail, pre-frail and frail elderly women: a pilot study. Aging Clin Exp Res. 2015;27:621-629.
Cerri AP, Teruzzi F, Gregorio M, Bellelli G, Annoni G. Takotsubo cardiomyopathy in an elderly patient with severe Alzheimer's disease: a case report. J Am Med Dir Assoc. 2012;13:207-209.
Guidoni S V, Pellicano C, La Starza S, Spalloni A, Rasura M. Tako tsubo and ischemic stroke in a patient with Alzheimer's disease. Aging Clin Exp Res. 2014;26:673-675.
Zuin M, Dal Santo P, Picariello C, et al. Takotsubo cardiomyopathy in an elderly woman with Alzheimer's disease: a rare association. Case report and mini-review of the literature. J Am Geriatr Soc. 2016;64:916-917.
Amin H, Shepherd Z. Stress cardiomyopathy in association with severe agitation in dementia. Cureus. 2019;11:e4531.
Strøm C, Rasmussen LS, Steinmetz J. Practical management of anaesthesia in the elderly. Drugs Aging. 2016;33:765-777.
Chen C, Fang C-C, Wang S-P. Reversible atrial lead dysfunction of DDD pacemaker after recent inferior myocardial infarction. Angiology. 2004;55:451-454.
Cascio WE, Yang H, Johnson TA, Muller-Borer BJ, Lemasters JJ. Electrical properties and conduction in reperfused papillary muscle. Circ Res. 2001;89:807-814.
Brunetti ND, D'Arienzo G, Sai R, et al. Delayed ventricular pacing failure and correlations between pacing thresholds, left ventricular ejection fraction, and QTc values in a male with takotsubo cardiomyopathy. Clin Cardiol. 2018;41:1487-1490.
Wissner E, Fortuin FD, Scott LR, Altemose GT. Reversible pacemaker dysfunction in a patient with transient cardiac apical ballooning syndrome: a case report. Europace. 2008;10:1105-1107.
Daoko J, Rajachandran M, Savarese R, Orme J. Biventricular takotsubo cardiomyopathy: case study and review of literature. Texas Hear Inst J. 2013;40:305-311.
Madias JE. Low prevalence of diabetes mellitus in patients with takotsubo syndrome: a plausible “protective” effect with pathophysiologic connotations. Eur Hear J Acute Cardiovasc Care. 2016;5:164-170.