![]() ![]() (see Supplementary Table 1 for ICD-10 codes used in this study). It contains de-identified clinical and nonclinical data that support readmission analysis, such as verified patient linkage number that identifies discharges belonging to the same patient, length of stay, and up to 40 diagnoses and 25 procedures collected for each patient using the International Classification of Diseases, Tenth Revision, Clinical Modification, ICD-10-CM. 5 In 2018, the NRD contained data from 28 states, accounting for 58.7% of all US hospitalizations. ![]() The NRD is a unique and powerful database developed for the Healthcare Cost and Utilization Project (HCUP) and designed to support various analyses of national readmission rates for all patients, regardless of expected payer for hospital stay. Therefore, we aim to identify the incidence and risk factors of ECV-associated TCM in patients with AF undergoing ECV. This presentation’s literature is limited and exists mainly in case reports, making estimating incidence impractical. To date, ECV-associated TCM was considered a rare complication of ECV in patients with AF undergoing ECV. Physical or emotional triggers increased the catecholamine significantly, causing myocardial dysfunction. Catecholamine-induced cardiotoxicity is one of the supported theories. The mechanism of this disease is still unknown. Takotsubo cardiomyopathy (TCM) is one of the reported causes of myocardial dysfunction after cardioversion. Other complications include arrhythmias, myocardial dysfunction, thromboembolism, and esophageal injury related to transesophageal echocardiography (TEE). 2 Transient hypotension is another benign complication that can resolve with intravenous fluid administration. Skin irritation, pain, and burn are the most common morbidities, with moderate-to-severe pain occurring in up to 23%. Electrical cardioversion (ECV) is the fastest way to establish sinus rhythm compared to antiarrhythmic medications and ablation. 1 Rhythm control is an essential strategy in symptomatic patients. The majority of patients recover within 2 weeks with supportive care.Ītrial fibrillation (AF) is the most common arrhythmia worldwide, with prevalence increasing with age. Female patients have a 50-fold increased risk, but DM is associated with a 3-fold risk reduction. Cardioversion-associated takotsubo cardiomyopathy is a rare complication in patients with atrial fibrillation who underwent electrical cardioversion. The recovery time is less than 1 week in milder cases but can take up to 2 weeks in severe cases. Acute heart failure due to apical type takotsubo cardiomyopathy is the most common presentation within 48 hours. The systematic review included 13 patients (mean age of 74.8 ± 9.6 years and 77% were female). Female sex is an independent predictor of electrical cardioversion-associated takotsubo cardiomyopathy, while diabetes mellitus is associated with less risk of electrical cardioversion-associated takotsubo cardiomyopathy. 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). Baseline characteristics and clinical presentation were displayed. 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. 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. We aimed to determine the incidence of cardioversion-associated takotsubo cardiomyopathy using a National Readmission Database 2018 and a systematic review. The incidence of cardioversion-associated takotsubo cardiomyopathy in patients with atrial fibrillation undergoing electrical cardioversion is unknown. ![]()
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