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  • Title: Supra-Hisian Conduction Block as an Unusual Presenting Feature of Takotsubo Cardiomyopathy.
    Author: Prabhu MA, Pai PG, Vupputuri A, Shekhar S, Harikrishnan MS, Kumaraswamy NU.
    Journal: Pacing Clin Electrophysiol; 2017 May; 40(5):596-599. PubMed ID: 28000218.
    Abstract:
    BACKGROUND: Atrioventricular (AV) block is rare in Takotsubo cardiomyopathy (TC). CASE REPORT: A 66-year-old female presented with fatigue. Her electrocardiogram revealed 3:2 Mobitz Type II AV block, confirmed to be supra-Hisian by electrophysiological study. Echocardiogram and left ventricular angiogram showed moderate left ventricular dysfunction and apical ballooning, whereas coronary angiogram revealed mildly ectatic coronaries. At 2 weeks AV block persisted, needing permanent pacemaker implantation. At 1-month follow-up, she had normal ventricular function and no AV block. CONCLUSION: Delayed recovery of AV conduction is possible in TC, thus implying to wait for a longer period before implanting a pacemaker.
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