title: Supra-Hisian Conduction Block as an Unusual Presenting Feature of Takotsubo Cardiomyopathy.
abstract: BACKGROUND
  Atrioventricular (AV) block is rare in Takotsubo cardiomyopathy (TC).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Delayed recovery of AV conduction is possible in TC, thus implying to wait for a longer period before implanting a pacemaker.
authors.affiliation: Department of Cardiology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala, India.
authors.forename: Mukund Aravind
authors.initials: MA
authors.lastname: Prabhu
authors.affiliation: Department of Cardiology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala, India.
authors.forename: Praveen Gopalakrishna
authors.initials: PG
authors.lastname: Pai
authors.affiliation: Department of Cardiology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala, India.
authors.forename: Anjith
authors.initials: A
authors.lastname: Vupputuri
authors.affiliation: Department of Cardiology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala, India.
authors.forename: Saritha
authors.initials: S
authors.lastname: Shekhar
authors.affiliation: Department of Cardiology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala, India.
authors.forename: Madhavankutty Santhakumari
authors.initials: MS
authors.lastname: Harikrishnan
authors.affiliation: Department of Cardiology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala, India.
authors.forename: Natarajan Umayammal
authors.initials: NU
authors.lastname: Kumaraswamy
mesh_terms: D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D035583:Rare Diseases / Q000175:diagnosis / Q000209:etiology; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis*
keywords: AV block; Takotsubo cardiomyopathy; supra-Hisian