Persistent atrial fibrillation occurs in 1.7% of new hyperthyroid patients, with over 56% spontaneously reverting to sinus rhythm and elective cardioversion maintaining sinus rhythm in 56.7% at 10 years.
Observational
Atrial fibrillation is often induced in patients with hyperthyroidism and may trigger heart failure. Its prevalence and outcome were examined to obtain up-to-date information. Persistent atrial fibrillation was observed in approximately 1.7% of new hyperthyroid patients. It occurs more frequently in males (2.86%) than in females (1.36%), even though the number of male hyperthyroid patients is only one fifth of female patients. The rate increased with age, being 8% in the patients older than 70 years old. The initial treatment is to control the heart rate with routine pharmacologic therapy and to start antithyroid therapy as quickly as possible. Attempted cardioversion should be deferred until approximately the fourth month of maintaining a euthyroid state, because more than 56% of atrial fibrillation spontaneously reverts to sinus rhythm when the thyroid hormone levels start to decline. Elective cardioversion for those whose atrial fibrillation persists is highly effective and sinus rhythm maintenance rates were 56.7% and 47.6% at the 10th and the 14th year, respectively, even though the duration of atrial fibrillation prior to cardioversion was extremely long (35.0 ± 29.0 months).
SHIMIZU et al. (Sat,) conducted a observational in Hyperthyroidism and Atrial Fibrillation. Antithyroid therapy and elective cardioversion was evaluated on Prevalence of persistent atrial fibrillation and sinus rhythm maintenance. Persistent atrial fibrillation occurs in 1.7% of new hyperthyroid patients, with over 56% spontaneously reverting to sinus rhythm and elective cardioversion maintaining sinus rhythm in 56.7% at 10 years.
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