Amiodarone-induced hyperthyroidism was associated with left ventricular assist device (LVAD) thrombosis in 2 reported cases, likely due to a hypercoagulable state.
Case Report (n=2)
Amiodarone-induced hyperthyroidism may create a hypercoagulable state that potentiates the risk of LVAD thrombosis.
Ventricular arrhythmias occurs in 20-50% of patients supported with left ventricular assist devices (LVAD). Ventricular arrhythmias are well tolerated with LVAD support but long-term consequences include worsening right ventricular function. Management of ventricular arrhythmias in LVAD patients includes use of antiarrhythmic agents or ablation. Amiodarone has been used a first-line agent to treat ventricular arrhythmias post-LVAD implantation. Chronic treatment with amiodarone for arrhythmias can result in hyperthyroidism and hypothyroidism in 5-10% of patients. Hyperthyroidism is known to cause endothelial dysfunction, alterations in coagulation, and fibrinolytic pathways favoring hypercoagulable state. We describe two cases of left ventricular assist device (LVAD) thrombosis potentiated by amiodarone-induced hyperthyroidism (AIT) and discuss pathophysiological mechanisms for hypercoagulable state induced by hyperthyroidism.
Rajapreyar et al. (Tue,) conducted a case report in Left ventricular assist device (LVAD) thrombosis and amiodarone-induced hyperthyroidism (n=2). Amiodarone was evaluated on LVAD thrombosis. Amiodarone-induced hyperthyroidism was associated with left ventricular assist device (LVAD) thrombosis in 2 reported cases, likely due to a hypercoagulable state.
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