title: Burden of arrhythmias in patients with Takotsubo cardiomyopathy (apical ballooning syndrome).
abstract: BACKGROUND
  The objective of our study was to assess the burden of arrhythmias, the gender differences in occurrence of arrhythmias and the impact of these arrhythmias on hospitalization outcomes in patients with Takotsubo Cardiomyopathy (TTC).
  
  
  METHODS
  TTC and various arrhythmias were identified using appropriate ICD-9-CM codes from Nationwide Inpatient Sample (NIS) discharge records 2006-2010. Length of hospital stay (LOS), in-hospital mortality and total charges were used to assess the impact of the arrhythmias on TTC hospitalization. All analyses were performed using SASv9.2 (Cary Institute Inc., Cary, NC).
  
  
  RESULTS
  A total of 16,450 patients were included in the study and 26% (n=4296) of patients had cardiac arrhythmias. Following arrhythmias were present in the descending order of frequency: atrial fibrillation (Afib) 6.9%, ventricular tachycardia (VT) 3.2%, atrial flutter (Afl) 1.9%, ventricular fibrillation and flutter 1%, paroxysmal supraventricular tachycardia (PSVT) 0.8%. Nearly two percent of the patients had sudden cardiac arrest (SCA). Males were more likely to have cardiac arrhythmias in general compared to females (OR: 1.5, 95% CI: 1.3-1.7, p-value 0.001). Occurrence of ventricular tachycardia (OR: 1.7, 95% CI: 1.3-2.2, p-value<0.001) and sudden cardiac arrest OR: 1.6, 95% CI: 1.1-2.2, p<0.001) were significantly higher in males. In contrast, Afib was significantly less in males compared to females (OR:0.8, 95% CI:0.6-0.9). Patients with arrhythmias had significantly longer length of stay, and increased cost of hospitalization and mortality.
  
  
  CONCLUSIONS
  Arrhythmias are present in nearly one-quarter of patients with TTC and worsen the outcome. While TTC has been established as a disease mainly of females, life threatening arrhythmias like VT and SCA are more common in males.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, United States. Electronic address: spant@uams.edu.
authors.forename: Sadip
authors.initials: S
authors.lastname: Pant
authors.forename: Abhishek
authors.initials: A
authors.lastname: Deshmukh
authors.forename: Kathan
authors.initials: K
authors.lastname: Mehta
authors.forename: Apurva O
authors.initials: AO
authors.lastname: Badheka
authors.forename: Tushar
authors.initials: T
authors.lastname: Tuliani
authors.forename: Nileshkumar J
authors.initials: NJ
authors.lastname: Patel
authors.forename: Kaustubh
authors.initials: K
authors.lastname: Dabhadkar
authors.forename: Abhiram
authors.initials: A
authors.lastname: Prasad
authors.forename: Hakan
authors.initials: H
authors.lastname: Paydak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000191:economics / Q000401:mortality*; D017281:Cost of Illness; D016208:Databases, Factual / Q000639:trends; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000639:trends*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000191:economics / Q000639:trends; D054549:Takotsubo Cardiomyopathy / Q000191:economics / Q000401:mortality*; D055815:Young Adult
keywords: Arrhythmias; Gender; Outcome; Takotsubo cardiomyopathy (ttc)