Recurrent Ventricular Fibrillation Associated With Graves' Disease: A Case Report

Area of Science:

• Cardiology
• Endocrinology
• Internal Medicine

Background:

• Tachyarrhythmias are known complications of thyrotoxicosis.
• The association between thyrotoxicosis and ventricular fibrillation remains largely unknown.
• Graves' disease is a common cause of hyperthyroidism.

Purpose of the Study:

• To report a case of recurrent ventricular fibrillation in a patient with Graves' disease.
• To evaluate the efficacy of an implantable cardioverter defibrillator in managing this condition.
• To discuss the implications for preventing sudden cardiac death in hyperthyroid patients.

Main Methods:

• Case report of a 33-year-old female patient presenting with ventricular fibrillation cardiac arrest.
• Diagnosis of Graves' disease with poorly controlled hyperthyroidism.
• Management included intensive care, extracorporeal membrane oxygenator, and implantation of an implantable cardioverter defibrillator; subsequent radioactive iodine-131 therapy.

Main Results:

• The patient experienced recurrent ventricular fibrillation, which was successfully managed by the implantable cardioverter defibrillator, preventing sudden cardiac death.
• Radioactive iodine-131 therapy led to normal thyroid function and a normal sinus rhythm.
• The implantable cardioverter defibrillator demonstrated effectiveness in secondary prevention.

Conclusions:

• Ventricular fibrillation is a rare but potentially fatal complication of hyperthyroidism.
• Implantable cardioverter defibrillator therapy should be considered for secondary prevention in patients with hyperthyroidism, particularly those with poor control.
• Successful management with radioactive iodine-131 therapy highlights the importance of thyroid function normalization.