Short-term outcome of early electrical cardioversion for atrial fibrillation in hyperthyroid versus euthyroid...

Area of Science:

• Cardiology
• Endocrinology
• Internal Medicine

Background:

• Atrial fibrillation (AF) is a common cardiac complication of hyperthyroidism.
• The optimal timing for cardioversion in hyperthyroidism-induced AF is not well-defined.
• This study investigates the short-term outcomes of early electrical cardioversion for AF in hyperthyroid versus euthyroid individuals.

Purpose of the Study:

• To compare the effectiveness and recurrence rates of early electrical cardioversion for persistent AF in patients with and without hyperthyroidism.
• To evaluate the impact of hyperthyroid status on the success of cardioversion and AF recurrence.

Main Methods:

• Sixty-seven patients with persistent AF (10 days-12 months) were divided into euthyroid (n=36) and hyperthyroid (n=31) groups.
• Electrical cardioversion was performed using transthoracic and transesophageal echocardiography guidance.
• AF recurrence was assessed at one month post-cardioversion.

Main Results:

• One-month AF recurrence rates were similar between hyperthyroid (36.9%) and euthyroid (37.1%) groups (p=0.96).
• Within the hyperthyroid group, clinical hyperthyroidism showed a higher recurrence rate (52.6%) than subclinical hyperthyroidism (9.1%) (p=0.021).
• Neither clinical nor subclinical hyperthyroid subgroups differed significantly from the euthyroid group in recurrence rates.

Conclusions:

• Early electrical cardioversion is a viable option for patients presenting with persistent AF and hyperthyroidism.
• Prompt cardioversion for hyperthyroidism-associated AF yields outcomes comparable to those in euthyroid patients.
• Treatment timing for AF in hyperthyroid patients should prioritize early intervention.