Wakatsuki Daisuke, Asano Taku, Mase Hiroshi, Kurata Masaaki, Suzuki Hiroshi
Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
J Cardiol Cases. 2020 Jan 8;21(4):149-152. doi: 10.1016/j.jccase.2019.12.002. eCollection 2020 Apr.
Pacemaker implantations are minimally invasive procedures commonly used for patients with bradycardic arrhythmias. Takotsubo cardiomyopathy, which is usually induced by life-threatening stress hardly ever occurs after this minimally invasive procedure. Here, we experienced a patient who developed takotsubo cardiomyopathy leading to ventricular fibrillation the day after a pacemaker implantation. At that time, a cardiac echocardiogram and left ventriculogram revealed hypercontraction of the base of the heart and a decreased contraction of the apex. A coronary angiogram revealed no significant coronary stenosis. Ten days later, the electrocardiogram findings normalized, and an echocardiogram revealed that the left ventricular function had fully recovered. Therefore, we diagnosed this patient with takotsubo cardiomyopathy. In general, pacemaker implantations are routine procedures and fatal complications are low. We report a case that developed potentially fatal complications after a pacemaker implantation. < This patient developed in-hospital cardiac arrest due to ventricular fibrillation from takotsubo cardiomyopathy after a pacemaker implantation, which is of special interest because complications leading to in-hospital cardiac arrest just after a pacemaker implantation are rare. We consider this case report as an educational case that caused potentially fatal complications even after pacemaker implantation.>.
心脏起搏器植入术是常用于缓慢性心律失常患者的微创手术。应激性心肌病通常由危及生命的应激诱发,在这种微创手术后几乎从不发生。在此,我们遇到一名患者,在心脏起搏器植入术后第二天发生应激性心肌病并导致心室颤动。当时,心脏超声心动图和左心室造影显示心底过度收缩,心尖收缩减弱。冠状动脉造影显示无明显冠状动脉狭窄。十天后,心电图结果恢复正常,超声心动图显示左心室功能已完全恢复。因此,我们诊断该患者为应激性心肌病。一般来说,心脏起搏器植入术是常规手术,致命并发症发生率较低。我们报告一例在心脏起搏器植入术后发生潜在致命并发症的病例。<该患者在心脏起搏器植入术后因应激性心肌病导致心室颤动而发生院内心脏骤停,这一情况特别值得关注,因为在心脏起搏器植入术后不久导致院内心脏骤停的并发症很少见。我们将本病例报告视为一个具有教育意义的病例,即使在心脏起搏器植入术后也会引发潜在的致命并发症。>