Key result
A 15-year-old female with hyperthyroidism and atrial fibrillation successfully reverted to and maintained normal sinus rhythm following synchronized cardioversion and medical management.
Why the study?
Atrial fibrillation is exceedingly rare in children with structurally and functionally normal hearts.
Case Report (n=1)
No
Highlights a rare case of atrial fibrillation secondary to hyperthyroidism in a pediatric patient, successfully managed with methimazole and cardioversion.
Atrial fibrillation is exceedingly rare in children with structurally and functionally normal hearts. We present a novel case of a 15-year-old female with known hyperthyroidism who subsequently developed atrial fibrillation. She had been suffering from fatigue, heat intolerance and myalgias for 6 months. Her initial TSH was 0.01mU/L, and free T4 was 75.4 pmol/L, with a free T3 of >30.8 pmol/L. An electrocardiogram showed atrial fibrillation with a ventricular rate of 141 beats per minute. An echocardiogram demonstrated an enlarged left atrium and ventricle, with mild mitral regurgitation. She was treated with methimazole and underwent synchronized cardioversion. She subsequently returned to a euthyroid state and remained in normal sinus rhythm. In this case, we discuss the physiologic and arrhythmogenic properties of thyroid hormone, with a summary of the existing literature on atrial fibrillation in hyperthyroidism in children. Current guidelines for treatment of atrial fibrillation are also outlined.
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Subramonian et al. (2021) conducted a case report in Hyperthyroidism with Atrial Fibrillation (n=1). Synchronized cardioversion, methimazole, and bisoprolol was evaluated on Restoration of normal sinus rhythm and euthyroid state. A 15-year-old female with hyperthyroidism and atrial fibrillation successfully reverted to and maintained normal sinus rhythm following synchronized cardioversion and medical management.
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