PO-05-172 EPIDEMIOLOGY OF TAKOTSUBO CARDIOMYOPATHY WITH ARRHYTHMIAS AND THEIR COMPLICATIONS- AN UPDATED ANALYSIS

Abstract

Takotsubo cardiomyopathy (TCM) is a stress-induced cardiomyopathy that is usually readily reversible. However, it has been associated with many life-threatening arrhythmias. Prolonged QT, changes in cardiac cellular signaling due to catecholamine excess along with certain gender and genetic causes are considered to be the potential causes. We sought to assess the arrhythmia burden and associated complications in patients with Takotsubo cardiomyopathy. National Inpatient sample 2018-2020 was queried for adult patients (age> 18 years) with TCM. These patients were compared to the rest of the adults and analysed for underlying arrhythmias. Further, patients with TCM with and without underlying arrhythmias were studied to look for complications. A total of 200040 adult patients with TCM were admitted from 2018-2020 with a mean age of 67 years. 82.61% of them were females. Caucasians comprised 82.38%; African- Americans comprised 8.2% while the remaining 9.42% of patients with TCM belonged to other race categories (Hispanics, Native- Americans, etc). Patients with TCM were associated with a higher prevalence of arrhythmias as compared to patients without TCM (27.87% vs 16.98%; P<0.0001). Bradyarrhythmias including atrioventricular blocks (AV blocks) as well as tachyarrhythmias including supraventricular tachycardias and ventricular tachycardias were significantly more in the patients admitted with TCM (Table 1). Long QT syndrome and sick sinus syndrome were more prevalent in this patient subgroup as well. (Table 1) On comparing complications in a cohort of TCM, it was observed that mortality, cardiogenic shock, and cardiac tamponade were more commonly seen in patients with an underlying arrhythmia (complete heart block, ventricular tachycardia, ventricular fibrillation, and atrial fibrillation) than in patients without arrhythmias. Incidence of acute heart failure exacerbations was however not statistically different in these two groups. (Table 2) This study substantiates the fact that although TCM is reversible it is not free of complications. These patients are at significant risk of arrhythmias and subsequently further complications. It is advisable to monitor patients with TCM before discharge and warrants close outpatient monitoring as well.