(searched for: doi:10.1136/pgmj.41.481.663)
Postgraduate Medical Journal, Volume 58, pp 746-748; https://doi.org/10.1136/pgmj.58.686.746
A review of 22 patients with atrial fibrillation after the treatment of thyrotoxicosis, who underwent elective electrical cardioversion, showed that only 45% were still in sinus rhythm at 2 years and 36% in the long term (mean 7·4 years). There were no significant differences in factors assessed between those persisting in sinus rhythm and in those who relapsed. A delay in the initial curative treatment of thyrotoxicosis may be a factor in influencing the outcome.
Published: 1 January 1981
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BMJ (Clinical research ed.), Volume 2, pp 688-690; https://doi.org/10.1136/bmj.2.6088.688
In 262 patients with thyrotoxicosis and atrial fibrillation there were 26 episodes of arterial embolism (17 cerebral and nine elsewhere) in 21 patients. Twelve incidents occurred with active thyrotoxicosis, three on reversion to sinus rhythm, and 11 after the patients were euthyroid. This important complication is more common than is realised, and most patients should be put on prophylactic anticoagulants when first seen with atrial fibrillation.
Published: 31 December 1976
by Elsevier BV
Pharmacology & Therapeutics. Part C: Clinical Pharmacology and Therapeutics, Volume 1, pp 101-118; https://doi.org/10.1016/s0362-5486(76)80008-8
Nuklearmedizin / NuclearMedicine, Volume 10, pp 55-68; https://doi.org/10.1055/s-0038-1624734
Summary: A comparison of the effect of large and small doses of radioiodine in patients with cardiac thyrotoxicosis revealed that after large doses thyrotoxicosis recedes more rapidly but is associated with a high incidence of hypothyroidism in subsequent years. After small doses the incidence of hypothyroidism is smaller; there is, however, a high percentage of persisting thyrotoxicoses. The sensitivity to radioiodine is higher in diffuse goiter, in small goiters, and after thyroidectomy.Large and small doses have approximately the same effect on the regression of decompensation and the incidence of paroxysmal atrial fibrillation, provided that treatment is supplemented by thyrostatic, antiarrhythmic, cardiotonic, and diuretic drugs. Larger doses of radioiodine had a more favourable effect on the reversion to sinus rhythm in patients with permanent atrial fibrillation.
Scottish Medical Journal, Volume 14, pp 17-22; https://doi.org/10.1177/003693306901400103
Postgraduate Medical Journal, Volume 44, pp 885-890; https://doi.org/10.1136/pgmj.44.518.885
(1) Enlargement of the heart was found in 35% of a group of older patients with thyrotoxicosis who had no evidence of associated heart disease. Atrial fibrillation was present in 48% of patients with cardiac enlargement and in 10% with a normal sized heart. Both complications were more common when there was associated heart disease. (2) In patients with an enlarged heart but no associated heart disease a reduction in heart-size after treatment of thyrotoxicosis was observed in five of twenty-three who had sinus rhythm throughout, and in three of eleven who had atrial fibrillation on presentation with subsequent reversion to sinus rhythm. There was no reduction in heart size in ten who had persistent atrial fibrillation after completion of treatment. Reduction in heart size was most marked in patients who had presented with frank cardiac failure. (3) The incidence of cardiac enlargement and atrial fibrillation both increased with advancing age but whereas enlargement was common over 45 years atrial fibrillation was rarely seen under 55 years of age. Only one of thirteen patients with an enlarged heart under 55 years had atrial fibrillation. (4) It is concluded that enlargement of the heart may be a manifestation of thyrotoxic heart disease, that it may precede the onset of atrial fibrillation in some instances, and consequently that atrial fibrillation is not necessarily the cause of an enlarged heart in thyrotoxicosis.
Postgraduate Medical Journal, Volume 43, pp 756-762; https://doi.org/10.1136/pgmj.43.506.756