The Curious Clinicians 77 - Irregularly Irregular
Sep 21, 2023
The podcast explores the relationship between hyperthyroidism and atrial fibrillation, including the effects of hyperthyroidism on the heart and the potential causes of AFib. It also discusses the impact of T3 on cardiomyocytes, the association between fibrosis and hyperthyroidism, and the effects of thyroid-stimulating hormone levels on AFib risk.
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Diagnosing AFib Due to Hyperthyroidism
- Hannah, Tony, and Avi discuss their experiences diagnosing AFib caused by hyperthyroidism.
- They've sent numerous TSH tests but rarely uncovered hyperthyroidism as the sole cause unless other symptoms were obvious.
Hyperthyroidism and AFib Risk
- Large cohort studies show a 3-6 times higher relative risk of AFib in overt hyperthyroidism.
- Subclinical hyperthyroidism also increases risk, correlating linearly with free T4 levels.
Now vs. Later Effects
- Hyperthyroidism's impact on AFib has 'now' (immediate) and 'later' (long-term) effects.
- 'Now' involves hemodynamic (sympathetic) and electrophysiologic changes.