학술논문

Electrical Cardioversion-Associated Takotsubo Cardiomyopathy: A National Readmission Database 2018 Analysis and Systematic Review.
Document Type
Article
Source
Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi. Feb2023, Vol. 27 Issue 2, p62-68. 11p.
Subject
*DATABASES
*ELECTRICAL injuries
*ATRIAL fibrillation
*PATIENT readmissions
*DISEASE risk factors
*TAKOTSUBO cardiomyopathy
*HEART failure
Language
ISSN
2149-2263
Abstract
The incidence of cardi overs ion-a ssoci ated takotsubo cardiomyopathy in patients with atrial fibrillation undergoing electrical cardioversion is unknown. We aimed to determine the incidence of cardi overs ion-a ssoci ated takotsubo cardiomyopathy using a National Readmission Database 2018 and a systematic review. We identified all patients with the index diagnosis of atrial fibrillation who underwent electrical cardioversion and were readmitted within 30 days with a primary diagnosis of takotsubo cardiomyopathy by International Classification of Diseases, Tenth Revision, Clinical Modification codes to find the incidence and risk factors of the disease. A systematic review was performed by searching PubMed and Embase for patients with atrial fibrillation who underwent electrical cardioversion and developed takotsubo cardiomyopathy from inception to February 2022. Baseline characteristics and clinical presentation were displayed. Among 154 919 patients admitted with atrial fibrillation who underwent electrical cardioversion in National Readmission Database 2018, 0.027% were readmitted with takotsubo cardiomyopathy (mean age of 71.0 ± 3.5 years and 96.7% were female). Female sex is an independent predictor of electrical cardi overs ion-a ssoci ated takotsubo cardiomyopathy [adjusted odds ratio = 49.77 (95% CI: 5.90-419.87)], while diabetes mellitus is associated with less risk of electrical cardi overs ion-a ssoci ated takotsubo cardiomyopathy [adjusted odds ratio = 0.31 (95% CI: 0.10-0.99)]. The systematic review included 13 patients (mean age of 74.8 ± 9.6 years and 77% were female). Acute heart failure due to apical type takotsubo cardiomyopathy is the most common presentation within 48 hours. The recovery time is less than 1 week in milder cases but can take up to 2 weeks in severe cases. Cardi overs ion-a ssoci ated takotsubo cardiomyopathy is a rare complication in patients with atrial fibrillation who underwent electrical cardioversion. Female patients have a 50-fold increased risk, but DM is associated with a 3-fold risk reduction. The majority of patients recover within 2 weeks with supportive care. [ABSTRACT FROM AUTHOR]