Gencer, Baris; Cappola, Anne R.; Rodondi, Nicolas; Collet, Tinh-Hai (2022). Challenges in the Management of Atrial Fibrillation With Subclinical Hyperthyroidism. Frontiers in endocrinology, 12, p. 795492. Frontiers Research Foundation 10.3389/fendo.2021.795492
|
Text
Gencer_FrontEndocrinol_2022.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (831kB) | Preview |
Subclinical thyroid disorders have a high prevalence among older individuals and women. Subclinical hypothyroidism is diagnosed by elevated serum levels of thyroid-stimulating hormone (TSH) with thyroxine levels within the reference range, and subclinical hyperthyroidism is diagnosed by low TSH in conjunction with thyroxine and triiodothyronine levels within reference ranges. Atrial fibrillation is the most commonly diagnosed cardiac arrhythmia and has been associated with an increased risk of mortality, heart failure, stroke, and depression. Mechanistic data from animal and human physiology studies as well as observational data in humans support an association of subclinical hyperthyroidism with atrial fibrillation. Guidelines recommend the measurement of TSH in the evaluation of new-onset atrial fibrillation. All patients with overt hyperthyroidism should be treated, and treatment of subclinical hyperthyroidism should be considered in patients older than 65 years with TSH < 0.4 mlU/L, or in younger patients with TSH < 0.1 mlU/L. Guidelines also recommend screening for AF in patients with known hyperthyroidism. Wearable devices that measure the heart electrical activity continuously may be a novel strategy to detect atrial fibrillation in patients at risk. In this review, we explore the interplay between thyroid hormones and atrial fibrillation, management controversies in subclinical hyperthyroidism, and potential strategies to improve the management of atrial fibrillation in patients with subclinical hyperthyroidism.
Item Type: |
Journal Article (Review Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine 04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM) |
UniBE Contributor: |
Gencer, Baris Faruk, Rodondi, Nicolas |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
1664-2392 |
Publisher: |
Frontiers Research Foundation |
Funders: |
[4] Swiss National Science Foundation |
Language: |
English |
Submitter: |
Doris Kopp Heim |
Date Deposited: |
11 Jan 2022 19:14 |
Last Modified: |
30 Dec 2022 10:31 |
Publisher DOI: |
10.3389/fendo.2021.795492 |
PubMed ID: |
35058884 |
BORIS DOI: |
10.48350/164421 |
URI: |
https://boris.unibe.ch/id/eprint/164421 |
Actions (login required)
 |
Edit item |