Reply to the Editor— Implantation of permanent devices in patients with Takotsubo syndrome

We thank Madias, Santoro, and colleagues for their interest in our work on the frequency and management of arrhythmias in patients with Takotsubo syndrome (TTS).1 All arrhythmic events in our patient population were documented during the acute phase of the disease. We did not observe a connection between the clinical course of TTS and the occurrence of certain types of arrhythmias that would suggest an early predominance of ventricular arrhythmias and a delayed emergence of bradyarrhythmias. However, 17 of 35 patients with events (48.6%) experienced the following arrhythmias before admission to our institutions and diagnosis of TTS: complete atrioventricular block (n = 5), ventricular fibrillation (n = 5), ventricular tachycardia (n = 3), sinoatrial block (n = 2), and asystole (n = 2).