Department of Internal Medicine, Bassett Healthcare Network, Cooperstown, NY, USA.
Department of Internal Medicine, Amita Health Saint Francis Hospital, Evanston, IL, USA.
Anatol J Cardiol. 2023 Feb;27(2):62-68. doi: 10.14744/AnatolJCardiol.2022.2236.
The incidence of cardioversion-associated takotsubo cardiomyopathy in patients with atrial fibrillation undergoing electrical cardioversion is unknown. We aimed to determine the incidence of cardioversion-associated 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 cardioversion-associated takotsubo cardiomyopathy [adjusted odds ratio = 49.77 (95% CI: 5.90-419.87)], while diabetes mellitus is associated with less risk of electrical cardioversion-associated 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. Cardioversion-associated 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.
心房颤动患者电复律后与电复律相关的 Takotsubo 心肌病的发生率尚不清楚。我们旨在使用 2018 年国家再入院数据库和系统评价来确定与电复律相关的 Takotsubo 心肌病的发生率。我们通过国际疾病分类，第十次修订，临床修正代码确定了所有索引诊断为心房颤动的患者，这些患者在电复律后 30 天内因 Takotsubo 心肌病的主要诊断而再次入院，以找到该疾病的发生率和危险因素。通过搜索 PubMed 和 Embase 对 2018 年从成立到 2022 年 2 月接受电复律并发生 Takotsubo 心肌病的心房颤动患者进行了系统评价。展示了基线特征和临床表现。在 2018 年国家再入院数据库中接受电复律的 154919 例心房颤动患者中，有 0.027%的患者因 Takotsubo 心肌病再次入院（平均年龄为 71.0±3.5 岁，96.7%为女性）。女性是电复律相关 Takotsubo 心肌病的独立预测因素[调整后优势比=49.77（95%可信区间：5.90-419.87）]，而糖尿病与电复律相关的 Takotsubo 心肌病风险较低相关[调整后优势比=0.31（95%可信区间：0.10-0.99）]。系统评价纳入了 13 例患者（平均年龄为 74.8±9.6 岁，77%为女性）。急性心力衰竭是心尖型 Takotsubo 心肌病 48 小时内最常见的表现。轻症患者的恢复期小于 1 周，但重症患者的恢复期可长达 2 周。电复律相关的 Takotsubo 心肌病是接受电复律的心房颤动患者的罕见并发症。女性患者的风险增加了 50 倍，但糖尿病的风险降低了 3 倍。大多数患者通过支持性治疗在 2 周内康复。
