Key result
A 74-year-old female with hypothyroidism-induced complete atrioventricular block experienced refractory bradycardia despite normalization of thyroid function, requiring a permanent pacemaker.
Why the study?
Hypothyroidism is a rare cause of complete atrioventricular block, which is generally considered reversible with thyroid replacement therapy.
Case Report (n=1)
Complete AVB secondary to hypothyroidism may not always be reversible with thyroid replacement therapy and can require permanent pacemaker placement.
Persistent complete AVB after thyroid normalization may warrant pacing; leaves open reversibility in broader hypothyroid cohorts.
Thyroid hormone regulates the body's metabolism, and its insufficiency can result in a wide variety of manifestations, including fatigue, lethargy, constipation, cold intolerance, and change in voice. Hypothyroidism also affects the cardiovascular system and can cause decreased cardiac output, increased systemic vascular resistance, pericardial effusion, bradycardia, and heart block. Hypothyroidism is a rare cause of complete atrioventricular block (AVB), which is generally thought to be reversible after thyroid replacement therapy. Here, we report a case of a 74-year-old female who presented to our hospital with lower extremity swelling and fatigue. She was diagnosed with hypothyroidism based on her thyroid function test. An electrocardiogram (ECG) revealed a complete AVB, and she was started on thyroid replacement therapy. During the second week of thyroid replacement therapy, she experienced episodes of bradycardia, and ECG still showed a complete AVB; despite normalization of her thyroid function, prompting placement of a pacemaker. The patient was discharged with endocrinology and electrophysiologist (EP) follow-upi
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Khan et al. (2022) conducted a case report in Complete atrioventricular block secondary to hypothyroidism (n=1). Levothyroxine and dual-chamber pacemaker was evaluated on Resolution of complete AV block. A 74-year-old female with hypothyroidism-induced complete atrioventricular block experienced refractory bradycardia despite normalization of thyroid function, requiring a permanent pacemaker.
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