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Readers' Comments: Was the Interatrial Block in Patients With Takotsubo Syndrome in the Spanish National RETAKO Registry Partially or Totally Reversible?

      I very much enjoyed reading the contribution by Martín-Demiguel et al
      • Martín-Demiguel I.
      • Núñez-Gil I.J.
      • Pérez-Castellanos A.
      • Vedia O.
      • Uribarri A.
      • Durán-Cambra A.
      • Martín-García A.
      • Corbí-Pascual M.
      • Guillén Marzo M.
      • Martínez-Sellés M.
      Prevalence and significance of interatrial block in takotsubo syndrome (from the RETAKO Registry).
      in the American Journal of Cardiology, reporting for first time on the prevalence of interatrial block (IAB) in patients with takotsubo syndrome (TTS) from the Spanish National RETAKO Registry. The authors found in their 246 patients that 61% had a normal P wave, 24% (58 patients) had a partial IAB, defined as P-wave duration of ≥120 ms and positive morphology in inferior leads, 5% (13 patients) had advanced IAB, defined as P-wave duration of ≥120 ms and biphasic (+/−) P-wave morphology in inferior leads, 7% had atrial fibrillation (AF), and 2% were pacemaker dependent in the admission electrocardiogram (ECG).
      • Martín-Demiguel I.
      • Núñez-Gil I.J.
      • Pérez-Castellanos A.
      • Vedia O.
      • Uribarri A.
      • Durán-Cambra A.
      • Martín-García A.
      • Corbí-Pascual M.
      • Guillén Marzo M.
      • Martínez-Sellés M.
      Prevalence and significance of interatrial block in takotsubo syndrome (from the RETAKO Registry).
      IAB is known to increase the risk of AF and stroke. At a mean 12 months follow-up, the authors observed a higher composite all-cause mortality/hospital readmission in patients with advanced IAB and AF than in the rest of the cohort, and advanced IAB was an independent predictor of the composite outcome.
      • Martín-Demiguel I.
      • Núñez-Gil I.J.
      • Pérez-Castellanos A.
      • Vedia O.
      • Uribarri A.
      • Durán-Cambra A.
      • Martín-García A.
      • Corbí-Pascual M.
      • Guillén Marzo M.
      • Martínez-Sellés M.
      Prevalence and significance of interatrial block in takotsubo syndrome (from the RETAKO Registry).
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      References

        • Martín-Demiguel I.
        • Núñez-Gil I.J.
        • Pérez-Castellanos A.
        • Vedia O.
        • Uribarri A.
        • Durán-Cambra A.
        • Martín-García A.
        • Corbí-Pascual M.
        • Guillén Marzo M.
        • Martínez-Sellés M.
        Prevalence and significance of interatrial block in takotsubo syndrome (from the RETAKO Registry).
        Am J Cardiol. 2019; (pii: S0002-9149(19)30328-5. [Epub ahead of print])https://doi.org/10.1016/j.amjcard.2019.03.028
        • Madias J.E.
        To the editor- implantation of permanent devices in patients with Takotsubo syndrome.
        Heart Rhythm. 2016; 13: e328