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COMPARISON OF CARDIAC ARRHYTHMIA TYPES BETWEEN HYPERTHYROID PATIENTS WITH GRAVES' DISEASE AND TOXIC NODULAR GOITER

E Turan1, I Can2, Y Turan2

  • 1Necmettin Erbakan University, Faculty of Medicine, Endocrinology and Metabolic Disorder, Konya, Turkey.

Acta Endocrinologica (Bucharest, Romania : 2005)
|June 1, 2019
PubMed

Insights

The cause of hyperthyroidism, whether Graves' disease (GD) or toxic nodular goiter (TNG), influences cardiac arrhythmias. Autoimmunity in GD correlated with ventricular tachycardia, while TNG was linked to atrial fibrillation, especially in older patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Hyperthyroidism, commonly caused by Graves' disease (GD) and toxic nodular goiter (TNG), is linked to an increased risk of cardiac arrhythmias.
  • Understanding the specific mechanisms driving hyperthyroidism is crucial for predicting associated cardiac complications.

Purpose of the Study:

  • To investigate whether the underlying cause of hyperthyroidism (autoimmune GD vs. non-autoimmune TNG) impacts the type of cardiac arrhythmias observed.
  • To differentiate arrhythmia profiles based on the etiology of hyperthyroidism.

Main Methods:

  • A comparative study included 20 patients with TNG and 16 with GD, all experiencing overt hyperthyroidism.
  • Data collected included patient demographics, thyroid hormone levels, autoantibody status, and imaging results.
  • All participants underwent 24-hour Holter ECG monitoring to assess cardiac rhythm.

Main Results:

  • Patients with GD were younger than those with TNG (48.9 vs. 62.9 years).
  • Graves' disease patients exhibited higher free T3 levels and a significantly greater incidence of nonsustained ventricular tachycardia (VT) (18.75%) compared to TNG patients (0%).
  • Toxic nodular goiter patients showed a significantly higher rate of paroxysmal atrial fibrillation (AF) (30%) compared to GD patients (0%).

Conclusions:

  • Paroxysmal AF was more prevalent in the TNG group, potentially linked to the older age of these patients.
  • Nonsustained VT occurred more frequently in the GD group, possibly related to higher free T3 levels or the autoimmune nature of the disease.
  • The etiology of hyperthyroidism appears to influence the specific type of cardiac arrhythmia, suggesting distinct pathophysiological pathways.
Abstract

Keywords:
ECG monitoringGraves’ diseaseHyperthyroidismarrhythmiatoxic nodular goiter

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