Atrial fibrillation hyperthyroidism


 * Associate Editor(s)-In-Chief: ; Varun Kumar, M.B.B.S.

Synonyms and related keywords: AF, Afib, fib

Overview
Atrial fibrillation occurs in 10% to 25% of patients with hyperthyroidism. Beta blockers and non-dihydropyridine calcium channel blockers may be used to control ventricular rate. In patients with hyperthyroidism, oral anticoagulation may be recommended to prevent systemic embolism. AF in the setting of thyrotoxicosis has been shown to be associated with decompensated heart failure.

==ACCF/AHA/HRS 2011 Guidelines- Hyperthyroidism (DO NOT EDIT) == {{cquote|

Class I
1. Administration of a beta blocker is recommended to control the rate of ventricular response in patients with AF complicating thyrotoxicosis, unless contraindicated. (Level of Evidence: B)

2. In circumstances when a beta blocker cannot be used, administration of a non dihydropyridine calcium channel antagonist (diltiazem or verapamil) is recommended to control the ventricular rate in patients with AF and thyrotoxicosis. (Level of Evidence: B)

3. In patients with AF associated with thyrotoxicosis, oral anticoagulation (INR 2.0 to 3.0) is recommended to prevent thromboembolism, as recommended for AF patients with other risk factors for stroke. (Level of Evidence: C)

4. Once a euthyroid state is restored, recommendations for antithrombotic prophylaxis are the same as for patients without hyperthyroidism. (Level of Evidence: C)}}

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Guideline Resources

 * ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation


 * 2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation


 * ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter