Citation: Journal of the American College of Cardiology. 76(4):451-464, 2020 Jul 28..Journal: Journal of the American College of Cardiology.Published: ; 2020ISSN: 0735-1097.Full author list: Nazari MA; Rosenblum JS; Haigney MC; Rosing DR; Pacak K.UI/PMID: 32703516.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Washington Hospital CenterDepartment(s): Medicine/Internal MedicineActivity type: Journal Article.Medline article type(s): Journal Article | ReviewOnline resources: Click here to access onlineDigital Object Identifier: https://dx.doi.org/10.1016/j.jacc.2020.04.080 (Click here)Abbreviated citation: J Am Coll Cardiol. 76(4):451-464, 2020 Jul 28.Abstract: Pheochromocytomas, arising from chromaffin cells, produce catecholamines, epinephrine and norepinephrine. The tumor biochemical phenotype is defined by which of these exerts the greatest influence on the cardiovascular system when released into circulation in high amounts. Action on the heart and vasculature can cause potentially lethal arrhythmias, often in the setting of comorbid blood pressure derangements. In a review of electrocardiograms obtained on pheochromocytoma patients (n = 650) treated at our institution over the last decade, severe and refractory sinus tachycardia, atrial fibrillation, and ventricular tachycardia were found to be the most common or life-threatening catecholamine-induced tachyarrhythmias. These arrhythmias, arising from catecholamine excess rather than from a primary electrophysiologic substrate, require special considerations for treatment and complication avoidance. Understanding the synthesis and release of catecholamines, the adrenoceptors catecholamines bind to, and the cardiac and vascular response to epinephrine and norepinephrine underlies optimal management in catecholamine-induced tachyarrhythmias. Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.