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Arrhythmia and thyroid dysfunction

Arrhythmie und Schilddrüsendysfunktion

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Abstract

Context

Arrhythmia is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of arrhythmia in patients with overt and subclinical thyroid disease and discuss the management of this arrhythmia.

Evidence acquisition

A literature search was carried out for reports published with the following terms: thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinase, atrial flutter, supraventricular arrhythmia, ventricular arrhythmia, ventricular tachycardia, ventricular fibrillation, torsade de pointes, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English.

Evidence analysis

The outcome of this analysis suggests that patients with untreated overt clinical or subclinical thyroid dysfunction are at increased risk of arrhythmia. Hyperthyroidism increased atrial arrhythmia; however, hypothyroidism increased ventricular arrhythmia.

Conclusion

The early recognition and effective treatment of thyroid dysfunction in patients with arrhythmia is mandatory because the long-term prognosis of arrhythmia may be improved with the appropriate treatment of thyroid dysfunction.

Zusammenfassung

Kontext

Arrhythmien sind ein wesentlicher Grund für Morbidität und Moralität in Europa wie in den USA. Ziel dieser Review-Arbeit war daher das Assessment von Ergebnissen prospektiver Studien zur Evaluation des Arrhythmierisikos für Patienten mit manifester und subklinischer Schilddrüsenerkrankungen. Ferner wird das Management dieser thyreoidassoziierter Arryhthmien diskutiert.

Erfassung der Evidenz

Gesucht wurde mit folgenden Begriffen: Schilddrüse, Hypothyreose, Hyperthyreose, subklinische Hyperthyreose, subklinische Hypothyreose, Levothyroxin, Trijodthyronin, Thyreostatika, Radiojod, Dejodinasen, Vorhofflattern, supraventrikuläre Arrhythmie, ventrikuläre Arrhythmie, ventrikuläre Tachykardie, Ventrikelflimmern, Torsade de pointes, Amiodaron und Vorhofflimmern. Die Suche war beschränkt auf englischsprachige Publikationen.

Evidenzanalyse

Die Ergebnisse der Analyse weisen darauf hin, dass Patienten mit unbehandelter (sub-)klinischer Schilddrüsendysfunktion ein erhöhtes Arrhythmierisiko haben. Eine Hyperthyreose verstärkte ein Vorhofflimmern, eine Hypothyreose dagegen eine ventrikuläre Arrhythmie.

Fazit

Unbedingt erforderlich sind das zeitnahe Erkennen und die effektive Behandlung einer Schilddrüsenfunktionsstörung, denn die langfristige Prognose einer Arrhythmie lässt sich durch entsprechende Behandlung der Schilddrüsendysfunktion verbessern.

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Conflict of interest. S. Marrakchi, F. Kanoun, S. Idriss, I. Kammoun, and S. state that there are no conflicts of interest. The accompanying manuscript does not include studies on humans or animals.

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  1. Abderrahmane Mami hospital, Tunis, Tunisia

    S. Marrakchi, F. Kanoun, S. Idriss, I. Kammoun & S. Kachboura

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Marrakchi, S., Kanoun, F., Idriss, S. et al. Arrhythmia and thyroid dysfunction. Herz 40 (Suppl 2), 101–109 (2015). https://doi.org/10.1007/s00059-014-4123-0

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