{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:58:51Z","timestamp":1792447131030,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Atrial fibrillation (AF) is a major risk factor for mortality. The prevalence, clinical correlates, and prognostic impact of AF in Takotsubo syndrome (TTS) have not yet been investigated in a large patient cohort. This study aimed to investigate the prevalence, clinical correlates, and prognostic impact of AF in patients with TTS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients with TTS were enrolled from the International Takotsubo Registry, which is a multinational network with 26 participating centers in Europe and the United States. Patients were dichotomized according to the presence or absence of AF at the time of admission. Of 1584 patients with TTS, 112 (7.1%) had AF. The mean age was higher (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and there were fewer women (\n              <jats:italic>P<\/jats:italic>\n              =0.046) in the AF than in the non\u2010AF group. Left ventricular ejection fraction was significantly lower (\n              <jats:italic>P<\/jats:italic>\n              =0.001), and cardiogenic shock was more often observed (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) in the AF group. Both in\u2010hospital (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and long\u2010term mortality (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) were higher in the AF group. Multivariable Cox regression analysis revealed that AF was independently associated with higher long\u2010term mortality (hazard ratio, 2.31; 95% CI, 1.50\u20133.55;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Among patients with AF on admission, 42% had no known history of AF before the acute TTS event, and such patients had comparable in\u2010hospital and long\u2010term outcomes compared with those with a history of AF.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In patients presenting with TTS, AF on admission is significantly associated with increased in\u2010hospital and long\u2010term mortality rates. Whether antiarrhythmics and\/or cardioversion are beneficial in TTS with AF should thus be tested in a future trial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01947621.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.014059","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T08:58:38Z","timestamp":1627462718000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Impact of Atrial Fibrillation on Outcome in Takotsubo Syndrome: Data From the International Takotsubo Registry"],"prefix":"10.1161","volume":"10","author":[{"given":"Ibrahim","family":"El\u2010Battrawy","sequence":"first","affiliation":[{"name":"First Department of Medicine Faculty of Medicine University Medical Centre Mannheim University of Heidelberg Mannheim Germany"},{"name":"German Center for Cardiovascular Researchpartner site Heidelberg\u2010Mannheim Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria L.","family":"Cammann","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart CenterUniversity Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart CenterUniversity Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad A.","family":"Szawan","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart CenterUniversity Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Di Vece","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart CenterUniversity Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelio","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart CenterUniversity Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Wischnewsky","sequence":"additional","affiliation":[{"name":"FB Mathematics and Computer Science University of Bremen Bremen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Hermes\u2010Laufer","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart CenterUniversity Hospital Zurich Zurich 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