Prevalence of Cardiac Arrhythmias in Hypothyroid and Euthyroid Patients

[helvella]

Well I never - a paper appearing to confirm the anecdotal reports that have filled the forum for years!

Horm Metab Res. 2017 May 4. doi: 10.1055/s-0043-105275. [Epub ahead of print]

Prevalence of Cardiac Arrhythmias in Hypothyroid and Euthyroid Patients.

Kannan L1, Kotus-Bart J2, Amanullah A3.

Author information

1 Department of Endocrinology, University of Pennsylvania, Philadelphia, PA, USA.

2 Department of Medicine, Pinnacle Health, Harrisburg, PA, USA.

3 Department of Cardiology, Einstein Medical Center, Philadelphia, PA, USA.

Abstract

The thyroid functions as a regulator of cardiac function and rhythm through genomic and nongenomic actions of triiodothyronine (T3) in cardiac myocytes. Atrial fibrillation is a common complication of thyrotoxicosis. Hypothyroidism is not considered a risk factor for arrhythmias despite well-known EKG changes in this condition. This case control study was conducted to analyze the differences, if any, in the prevalence of cardiac arrhythmias between hypothyroid patients and euthyroid controls. Three hundred and four consecutive patients admitted at our medical center for a period of one year were included in the study. The study population was divided into 2 groups (age, gender and race matched): patients with hypothyroidism and euthyroid subjects as a control group. Major arrhythmia data were obtained from telemetry recordings and from known past medical history. There were 152 subjects in each arm of the study. The mean age was 61.9 years. Mean TSH in hypothyroid group was 40.4 mIU/l (95% CI 33.3-47.5) (range 10.09-304, SE 3.62) and in euthyroid group was 0.89 mIU/l (95% CI 0.82-0.96). Chi-square analysis revealed a higher prevalence of ventricular tachycardia (p=0.04) and any ventricular arrhythmia in the hypothyroid group (p=0.007). This relatively large case control study revealed a statistically higher prevalence of ventricular arrhythmias in hypothyroidism. Our study has thrown light on the prevalence of arrhythmias in hypothyroidism and the observation of increased ventricular arrhythmias necessitates future large scale prospective studies to better define the risk of such ventricular arrhythmias and the effects of thyroid supplementation on this risk.

© Georg Thieme Verlag KG Stuttgart · New York.

PMID: 28472829

DOI: 10.1055/s-0043-105275

ncbi.nlm.nih.gov/pubmed/284...

[shaws]

I definitely agree with that wholeheartedly. We've had a few posts these last few days with 'arythmias' in their posts.

[shaws]

I need an interpretation please delicious21 as I have no knowledge about arythmias.

[TSH110 in reply to shaws]

shaws this has lots of great animated heart graphics showing those disorders

cardiachealth.org/bigemini

And guess what....it gives thyroid disorder as a cause of bigemini that needs to be rectified

[shaws in reply to TSH110]

Thanks for link. It is very interesting and it is true our heart to have perfect function needs thyroid hormones at optimum (if hypo) unfortunately most doctors/endocrinlogists are unaware of the purpose of thyroid hormones with the result we can suffer unnecessarily at times.

[humanbean]

Mean TSH in hypothyroid group was 40.4 mIU/l (95% CI 33.3-47.5) (range 10.09-304, SE 3.62) and in euthyroid group was 0.89 mIU/l (95% CI 0.82-0.96).

It makes me very emotional reading about hypothyroid patients being discovered with a TSH that high. The researchers are reporting on a group of patients who (in my opinion) must have been suffering for a long time to be that ill. But all this suffering seems to make no dent in treatment protocols around the world. Instead I've seen articles claiming that too many thyroid function tests are being done and money is being wasted. There was the recent paper posted by helvella that said there was no benefit in treating older people with subclinical hypothyroidism.

[shaws in reply to humanbean]

You are correct. I don't know how many times I complained but no-one ever thought of 'thyroid'. I myself did not know any people who had it.

They could easily do less blood tests if they treated patients optimally and would only need a blood test if symptoms occurred or a yearly one when stable like I now have. Also if patient isn't progressing lets provide then with alternatives without all the hoo haa that has gone on with T3 and NDT and stupid comments the professionals make.

NHS would save a fortune.

[shaws in reply to shaws]

Bearing in mind that I was discharged after an overnight stay in the A&E running on treadmill etc and discharged with 'probably viral with high cholesterol (that should have been a red flag) as a my demand to GP for a thyriod hormone test said TSH was 100 about ten days later. GP phoned to ask who told me to get blood test and I said 'I did'. Not including the specialists I paid and being given wrong diagnosis etc etc. one under anaesthetic. (I don't think your anger ever diminishes but you cannot let it affect your life).

Polaris cwill

[Katepots]

Surprise suprise! Doesn't it make you want to hit your head against a wall, like they are so clever just to be discovering this???! Bet that study cost thousands and will they do anything about it like prescribe us T3...

Sorry rant over 😳

Thanks for posting.

[Katepots]

I too have arterial fibrillation, extra beats and Wolf Parkinson Wight syndrome. Thought I was dying as a teenager. Had they discovered that I was hyper then with massive amounts of cortisol I wouldn't have then become very ill with hyperthyroidism so many years later!

[Musicmonkey]

BBC news this morning saying that over 3 million patients monitored for health risks are greatly more at risk of heart attack or stroke if obese.

Well thanks very much BTA!

Thank goodness, my weight is now on a very slow downward trajectory, but no thanks to current thyroid treatment offered by NHS (now self-medicating after a long journey of research with many thanks to this forum).

On the plus side, and to lift my disappointment and concern at this finding, hoping that this study will help to encourage the NHS/BTA to pay more attention to the causes of obesity.

I have always undertaken vigorous exercise, but haven't so far been able to get to, or maintain a healthy weight, despite a healthy diet.

bbc.co.uk/news/health-39936138

[TSH110]

Musicmonkey yeah the NHS were more than happy to have me weigh in at 12.5 stone on levothyroxine when I had been 8.5 stone all my adult life till hypo took hold. I looked and felt awful all bloated and puffy. I had dreadful heart pains and much earlier tests showed abnormalities in one chamber of the heart but nothing else was ever done about it. Only NDT slowly got me back to something more like my old self.

Once they get you on levothyroxine obesity becomes completely acceptable or you get blamed for overeating and not excercising enough - yet a thyroxine hormone therapy with T3 in it miraculously resolves it all including the heart pains/angina/arrhythmias

[Musicmonkey in reply to TSH110]

Well said TSH110

[Gcart]

I had all sort of palpatations had lots of monitoring. Echos , blood pressure monitor and most expensive of all a line into my heart with full theatre of docs and nurses (cant remember the name of that test)

Anyway , after TT for cancer and now treated with thyroid hormones ALL GONE dont get those awful palps anymore. I would colapse several times a day. Thyroid never checked

I was told thyroid cancer had no symptoms.🤡🤡 what a joke they are .

Wonder how much all the tests and hospital admissions cost

😳😳