Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillation
Atrial fibrillation (AF) is a common condition with a global estimated prevalence of 60 million cases, and the most common cardiac complication of hyperthyroidism, occurring in 5–15% of overtly hyperthyroid patients. Additionally, subclinical hyperthyroidism and high-normal free T4 have been associa...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2024-04-01
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| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/13/2/ETJ-23-0254.xml |
| _version_ | 1797221135838871552 |
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| author | Georgios Kostopoulos Grigoris Effraimidis |
| author_facet | Georgios Kostopoulos Grigoris Effraimidis |
| author_sort | Georgios Kostopoulos |
| collection | DOAJ |
| description | Atrial fibrillation (AF) is a common condition with a global estimated prevalence of 60 million cases, and the most common cardiac complication of hyperthyroidism, occurring in 5–15% of overtly hyperthyroid patients. Additionally, subclinical hyperthyroidism and high-normal free T4 have been associated with an increased risk in the development of AF. Hyperthyroidism-related AF is a reversible cause of AF, and the majority of patients spontaneously revert to sinus rhythm in 4–6 months during or after restoration of euthyroidism. Therefore, restoring thyroid function is an indispensable element in hyperthyroidism-related AF management. Rate control with beta-blockers consists another first-line therapy, reserving rhythm control in cases of persistent hyperthyroidism-related AF. It is still controversial whether hyperthyroidism is an independent risk factor of stroke in nonvalvular AF. As a result, initiating anticoagulation should be guided by the clinical thromboembolic risk score CHA2DS2-VASc score in the same way it is applied in patients with non-hyperthyroidism-related AF. Treatment with the novel direct oral anticoagulants appears to be as beneficial and may be safer than warfarin in patients with hyperthyroidism-related AF. In this review, we address the epidemiology, prognosis, and diagnosis of hyperthyroidism-related AF, and we discuss the management strategies and controversies in patients with hyperthyroidism-related AF. |
| first_indexed | 2024-04-24T13:00:38Z |
| format | Article |
| id | doaj.art-3b15a85674f34db7bf3e27bbe0a4f0ac |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-04-24T13:00:38Z |
| publishDate | 2024-04-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-3b15a85674f34db7bf3e27bbe0a4f0ac2024-04-05T11:45:04ZengBioscientificaEuropean Thyroid Journal2235-08022024-04-01132116https://doi.org/10.1530/ETJ-23-0254Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillationGeorgios Kostopoulos0Grigoris Effraimidis1Department of Endocrinology and Metabolism, Ippokratio General Hospital of Thessaloniki, GreeceDepartment of Endocrinology and Metabolic Diseases, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, GreeceAtrial fibrillation (AF) is a common condition with a global estimated prevalence of 60 million cases, and the most common cardiac complication of hyperthyroidism, occurring in 5–15% of overtly hyperthyroid patients. Additionally, subclinical hyperthyroidism and high-normal free T4 have been associated with an increased risk in the development of AF. Hyperthyroidism-related AF is a reversible cause of AF, and the majority of patients spontaneously revert to sinus rhythm in 4–6 months during or after restoration of euthyroidism. Therefore, restoring thyroid function is an indispensable element in hyperthyroidism-related AF management. Rate control with beta-blockers consists another first-line therapy, reserving rhythm control in cases of persistent hyperthyroidism-related AF. It is still controversial whether hyperthyroidism is an independent risk factor of stroke in nonvalvular AF. As a result, initiating anticoagulation should be guided by the clinical thromboembolic risk score CHA2DS2-VASc score in the same way it is applied in patients with non-hyperthyroidism-related AF. Treatment with the novel direct oral anticoagulants appears to be as beneficial and may be safer than warfarin in patients with hyperthyroidism-related AF. In this review, we address the epidemiology, prognosis, and diagnosis of hyperthyroidism-related AF, and we discuss the management strategies and controversies in patients with hyperthyroidism-related AF.https://etj.bioscientifica.com/view/journals/etj/13/2/ETJ-23-0254.xmlhyperthyroidismthyrotoxicosisatrial fibrillationstrokeanticoagulation |
| spellingShingle | Georgios Kostopoulos Grigoris Effraimidis Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillation European Thyroid Journal hyperthyroidism thyrotoxicosis atrial fibrillation stroke anticoagulation |
| title | Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillation |
| title_full | Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillation |
| title_fullStr | Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillation |
| title_full_unstemmed | Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillation |
| title_short | Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillation |
| title_sort | epidemiology prognosis and challenges in the management of hyperthyroidism related atrial fibrillation |
| topic | hyperthyroidism thyrotoxicosis atrial fibrillation stroke anticoagulation |
| url | https://etj.bioscientifica.com/view/journals/etj/13/2/ETJ-23-0254.xml |
| work_keys_str_mv | AT georgioskostopoulos epidemiologyprognosisandchallengesinthemanagementofhyperthyroidismrelatedatrialfibrillation AT grigoriseffraimidis epidemiologyprognosisandchallengesinthemanagementofhyperthyroidismrelatedatrialfibrillation |