Work

QTc Prolongation in Stress-Induced Cardiomyopathy

Year: 2026

Type: article

Abstract: BACKGROUND: Stress-induced cardiomyopathy (SCMP) is a transient cardiac syndrome often mimicking acute coronary syndrome. It is commonly associated with QT prolongation and can lead to serious dysrhythmias. CASE SUMMARY: A 73-year-old man with severe chronic obstructive pulmonary disorder developed SCMP during an acute chronic obstructive pulmonary disorder exacerbation, complicated by marked QTc prolongation (>650 ms) and recurrent pulseless polymorphic ventricular tachycardia. Invasive coronary angiography showed no obstructive coronary artery disease. Arrhythmias persisted despite electrolyte correction. Ultimately, pacing at 100 beats/min shortened QTc and prevented arrests. DISCUSSION: Although often self-limiting, stress cardiomyopathy may cause QT prolongation and arrhythmias. An underutilized therapy is high-rate pacing, which shortens QT and reduces early afterdepolarizations. TAKE-HOME MESSAGES: QT prolongation is not uncommon in SCMP, and severe prolongation often occurs, predisposing to polymorphic ventricular tachycardia and cardiac arrest. High-rate pacing is a highly effective, underutilized tool for acute management of severe QTc prolongation with associated ventricular tachycardia.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2026.108604

Authors: Jordan Holthe, Bradley Ternus, Rekha Mankad, Fadi Adel

Institution: Mayo Clinic

Language: English

Topic: Takotsubo Cardiomyopathy and Associated Phenomena

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850