Key result
Cardioversion, medical therapy, and catheter ablation successfully resolve thyrotoxic wide-complex tachycardia from Graves' disease.
Why the study?
The differential diagnosis of wide-complex tachycardia includes multiple etiologies and patients with tachyarrhythmias should be screened for hyperthyroidism as a reversible cause.
Case Report (n=1)
This case highlights that patients presenting with tachyarrhythmias, such as pre-excited atrial flutter, should be screened for hyperthyroidism as a reversible precipitating cause.
Hyperthyroidism may underlie wide-complex tachycardia in young adults; this case extends prior reports but leaves open causal mechanisms and management guidelines.
CASE SUMMARY: A 33-year-old gentleman presented with syncope, palpitations, and tremors. His 12-lead electrocardiogram demonstrated a wide-complex tachycardia at 300/min with intermittent changes in QRS morphology. Following urgent cardioversion, further electrocardiograms revealed the diagnosis, and biochemical testing showed hyperthyroidism secondary to Graves' disease. The patient commenced antiarrhythmic and hyperthyroid treatment and underwent definitive management with an electrophysiology study and ablation. TAKE-HOME MESSAGES: The differentials for a wide-complex tachycardia should include ventricular tachycardia, supraventricular tachycardia with aberrancy, pre-excitation, or pacing. Patients presenting with tachyarrhythmias should also be screened for hyperthyroidism as a precipitating and reversible cause.
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Kim et al. (2026) conducted a case report in Wide-complex tachycardia and hyperthyroidism (n=1). Cardioversion, antiarrhythmic and hyperthyroid treatment, and ablation was evaluated. A 33-year-old man presenting with extreme wide-complex tachycardia and tremors was diagnosed with Graves' disease and successfully managed with cardioversion, medical therapy, and ablation.
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