ArticleJACC. Case reports2026
QTc Prolongation in Stress-Induced Cardiomyopathy: A Case of Stabilization With Temporary High-Rate Pacing.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundStress-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.
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