Reduction of arrhythmias in primary hyperparathyroidism, by parathyroidectomy, evaluated with 24-h ECG monitoring

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Jessica Pepe1, Cristiana Cipriani1, Mario Curione1

  • 1Department of Internal Medicine and Medical Disciplines, 'Sapienza' University of Rome, Rome, Italy.

European Journal of Endocrinology
|June 8, 2018
PubMed

Insights

Primary hyperparathyroidism (PHPT) increases arrhythmia prevalence, linked to shorter QTc intervals. Parathyroidectomy significantly reduces premature beats and normalizes QTc in PHPT patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • Hypercalcemia is known to potentially induce cardiac arrhythmias.
  • Limited data exists on the prevalence of arrhythmias in primary hyperparathyroidism (PHPT) during daily life.

Purpose of the Study:

  • To investigate the prevalence of arrhythmias in PHPT patients compared to controls using 24-hour ECG monitoring.
  • To evaluate the impact of parathyroidectomy on arrhythmias in PHPT patients.

Main Methods:

  • A randomized study involving 26 postmenopausal women with PHPT and 26 controls.
  • PHPT patients were randomized to parathyroidectomy (n=13) or conservative management (n=13).
  • Evaluations included biochemical markers, bone density, standard ECG, and 24-hour ECG monitoring at baseline and 6 months.

Main Results:

  • PHPT patients exhibited higher calcium and parathyroid hormone levels, with increased supraventricular (SVBPs) and ventricular premature beats (VPBs).
  • PHPT patients had a significantly shorter QTc interval compared to controls, negatively correlated with ionized calcium.
  • Parathyroidectomy led to a significant reduction in SVBPs and VPBs and normalized QTc; conservative management showed no significant changes.

Conclusions:

  • The elevated prevalence of SVBPs and VPBs in PHPT is significantly reduced by parathyroidectomy.
  • This reduction is primarily associated with the normalization of the QTc interval, which is shortened by hypercalcemia.
Abstract

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