Key result
In a 47-year-old female, electrical cardioversion and hyperthyroidism management restored sinus rhythm, resolving severe mitral regurgitation and normalizing LV systolic function at 6 months.
Why the study?
Does rhythm control via electrical cardioversion reverse atrial remodeling and functional mitral regurgitation in a patient with atrial fibrillation and hyperthyroidism?
Case Report (n=1)
No
Does rhythm control via electrical cardioversion reverse atrial remodeling and functional mitral regurgitation in a patient with atrial fibrillation and hyperthyroidism?
Restoration of sinus rhythm in atrial fibrillation can reverse atrial remodeling and secondary functional mitral regurgitation.
Supports hypothesis that rhythm control may reverse functional MR in hyperthyroid AF; hypothesis-generating, should not yet change practice.
Atrial fibrillation is a common cardiac arrhythmia worldwide. In patients with hyperthyroidism, atrial fibrillation is the most common comorbid cardiac condition. Here, the authors report a case of a 47-year-old female with no significant medical history who presented with heart failure symptoms. Further analysis confirmed atrial fibrillation with a dilated atria and severe mitral regurgitation. In addition, she was found to be hyperthyroid. Accordingly, electrical cardioversion treatment was initiated, and her hyperthyroidism was managed. This resulted in her normal sinus rhythm being restored and subsequently being maintained. A repeat echocardiography 6 months later showed resolution of mitral regurgitation, improvement of atrial size and normalization of the left ventricular systolic function. Therefore, based on this case report, the authors suggest that atrial remodeling and functional mitral regurgitation secondary to atrial dilatation can be reversed by restoring and maintaining the sinus rhythm.
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Qahtani et al. (2019) conducted a case report in Atrial fibrillation and hyperthyroidism (n=1). Electrical cardioversion and hyperthyroidism management was evaluated on Resolution of mitral regurgitation, improvement of atrial size and normalization of left ventricular systolic function. In a 47-year-old female, electrical cardioversion and hyperthyroidism management restored sinus rhythm, resolving severe mitral regurgitation and normalizing LV systolic function at 6 months.
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