Cardiac arrest in takotsubo syndrome: results from the InterTAK Registry

Leonarda Galiuto, Filippo Crea, Sebastiano Gili, Victoria L. Cammann, Susanne A. Schlossbauer, Ken Kato, Fabrizio D’Ascenzo, Davide Di Vece, Stjepan Jurisic, Jozef Micek, Slayman Obeid, Beatrice Bacchi, Konrad A. Szawan, Flurina Famos, Annahita Sarcon, Rena Levinson, Katharina J. Ding, Burkhardt Seifert, Olivia Lenoir, Eduardo BossoneRodolfo Citro, Jennifer Franke, L. Christian Napp, Milosz Jaguszewski, Michel Noutsias, Thomas Münzel, Maike Knorr, Susanne Heiner, Hugo A. Katus, Christof Burgdorf, Heribert Schunkert, Holger Thiele, Johann Bauersachs, Carsten Tschöpe, Burkert M. Pieske, Lawrence Rajan, Guido Michels, Roman Pfister, Alessandro Cuneo, Claudius Jacobshagen, Gerd Hasenfuß, Mahir Karakas, Wolfgang Koenig, Wolfgang Rottbauer, Samir M. Said, Ruediger C. Braun-Dullaeus, Adrian Banning, Florim Cuculi, Richard Kobza, Thomas A. Fischer, Tuija Vasankari, K. E. Juhani Airaksinen, Grzegorz Opolski, Rafal Dworakowski, Philip Maccarthy, Christoph Kaiser, Stefan Osswald, Wolfgang Dichtl, Klaus Empen, Stephan B. Felix, Clément Delmas, Olivier Lairez, Ibrahim El-Battrawy, Ibrahim Akin, Martin Borggrefe, Ekaterina Gilyarova, Alexandra Shilova, Mikhail Gilyarov, John D. Horowitz, Martin Kozel, Petr Tousek, Petr Widimsky, David E. Winchester, Christian Ukena, Fiorenzo Gaita, Carlo Di Mario, Manfred B. Wischnewsky, Jeroen J. Bax, Abhiram Prasad, Michael Böhm, Frank Ruschitzka, Thomas F. Lüscher, Jelena R. Ghadri, Christian Templin

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23 Citations (Scopus)

Abstract

Aims We aimed to evaluate the frequency, clinical features, and prognostic implications of cardiac arrest (CA) in takotsubo syndrome (TTS).Methods and results We reviewed the records of patients with CA and known heart rhythm from the International Takotsubo Registry. The main outcomes were 60-day and 5-year mortality. In addition, predictors of mortality and predictors of CA during the acute TTS phase were assessed. Of 2098 patients, 103 patients with CA and known heart rhythm during CA were included. Compared with patients without CA, CA patients were more likely to be younger, male, and have apical TTS, atrial fibrillation (AF), neurologic comorbidities, physical triggers, and longer corrected QT-interval and lower left ventricular ejection fraction on admission. In all, 57.1% of patients with CA at admission had ventricular fibrillation/tachycardia, while 73.7% of patients with CA in the acute phase had asystole/pulseless electrical activity. Patients with CA showed higher 60-day (40.3% vs. 4.0%, P < 0.001) and 5-year mortality (68.9% vs. 16.7%, P < 0.001) than patients without CA. T-wave inversion and intracranial haemorrhage were independently associated with higher 60-day mortality after CA, whereas female gender was associated with lower 60-day mortality. In the acute phase, CA occurred less frequently in females and more frequently in patients with AF, ST-segment elevation, and higher C-reactive protein on admission.Conclusions Cardiac arrest is relatively frequent in TTS and is associated with higher short- and long-term mortality. Clinical and electrocardiographic parameters independently predicted mortality after CA.
Original languageEnglish
Pages (from-to)2142-2151
Number of pages10
JournalEuropean Heart Journal
Volume40
DOIs
Publication statusPublished - 2019

Keywords

  • Acute heart failure
  • Broken heart syndrome
  • Cardiac arrest
  • Outcome
  • Takotsubo syndrome

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