Arrhythmias in takotsubo cardiomyopathy

Acute emotional or physical stress can trigger a catecholamine-mediated myocardial stunning known as takotstubo cardiomyopathy (TCM). Although TCM is generally reversible, it can be associated with significant morbidity, including secondarily to cardiac arrhythmia. Lethal arrhythmias such as heart block, ventricular tachycardia, and ventricular fibrillation have been described. Repolarization abnormalities associated with TCM can lead to characteristic T-wave abnormalities and QT prolongation that place patients at increased risk for ventricular arrhythmia, including torsades de pointes. This article focuses on the arrhythmic complications associated with TCM and explores the underlying etiology of these arrhythmias.