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[[Atrial fibrillation]] occurs in '''10% to 25%''' of patients with [[hyperthyroidism]]. [[Beta blockers]] and [[CCB|non-dihydropyridine calcium channel blockers]] may be used to control ventricular rate.<ref name="pmid6734051">Clozel JP, Danchin N, Genton P, Thomas JL, Cherrier F (1984) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=6734051 Effects of propranolol and of verapamil on heart rate and blood pressure in hyperthyroidism.] ''Clin Pharmacol Ther'' 36 (1):64-9. PMID: [http://pubmed.gov/6734051 6734051]</ref> In patients with [[hyperthyroidism]], [[anticoagulation|oral anticoagulation]] may be recommended to prevent systemic embolism.<ref name="pmid1801769">Hirsh J (1991) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1801769 Oral anticoagulant drugs.] ''N Engl J Med'' 324 (26):1865-75. [http://dx.doi.org/10.1056/NEJM199106273242606 DOI:10.1056/NEJM199106273242606] PMID: [http://pubmed.gov/1801769 1801769]</ref> [[AF]] in the setting of [[thyrotoxicosis]] has been shown to be associated with [[heart failure|decompensated heart failure]].<ref name="pmid2329232">Robinson K, Frenneaux MP, Stockins B, Karatasakis G, Poloniecki JD, McKenna WJ (1990) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2329232 Atrial fibrillation in hypertrophic cardiomyopathy: a longitudinal study.] ''J Am Coll Cardiol'' 15 (6):1279-85. PMID: [http://pubmed.gov/2329232 2329232]</ref><ref name="pmid1822968">Russell JW, Biller J, Hajduczok ZD, Jones MP, Kerber RE, Adams HP (1991) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1822968 Ischemic cerebrovascular complications and risk factors in idiopathic hypertrophic subaortic stenosis.] ''Stroke'' 22 (9):1143-7. PMID: [http://pubmed.gov/1822968 1822968]</ref><ref name="pmid7666571">Shigematsu Y, Hamada M, Mukai M, Matsuoka H, Sumimoto T, Hiwada K (1995) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7666571 Mechanism of atrial fibrillation and increased incidence of thromboembolism in patients with hypertrophic cardiomyopathy.] ''Jpn Circ J'' 59 (6):329-36. PMID: [http://pubmed.gov/7666571 7666571]</ref>  
[[Atrial fibrillation]] occurs in '''10% to 25%''' of patients with [[hyperthyroidism]]. [[Beta blockers]] and [[CCB|non-dihydropyridine calcium channel blockers]] may be used to control ventricular rate.<ref name="pmid6734051">Clozel JP, Danchin N, Genton P, Thomas JL, Cherrier F (1984) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=6734051 Effects of propranolol and of verapamil on heart rate and blood pressure in hyperthyroidism.] ''Clin Pharmacol Ther'' 36 (1):64-9. PMID: [http://pubmed.gov/6734051 6734051]</ref> In patients with [[hyperthyroidism]], [[anticoagulation|oral anticoagulation]] may be recommended to prevent systemic embolism.<ref name="pmid1801769">Hirsh J (1991) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1801769 Oral anticoagulant drugs.] ''N Engl J Med'' 324 (26):1865-75. [http://dx.doi.org/10.1056/NEJM199106273242606 DOI:10.1056/NEJM199106273242606] PMID: [http://pubmed.gov/1801769 1801769]</ref> [[AF]] in the setting of [[thyrotoxicosis]] has been shown to be associated with [[heart failure|decompensated heart failure]].<ref name="pmid2329232">Robinson K, Frenneaux MP, Stockins B, Karatasakis G, Poloniecki JD, McKenna WJ (1990) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2329232 Atrial fibrillation in hypertrophic cardiomyopathy: a longitudinal study.] ''J Am Coll Cardiol'' 15 (6):1279-85. PMID: [http://pubmed.gov/2329232 2329232]</ref><ref name="pmid1822968">Russell JW, Biller J, Hajduczok ZD, Jones MP, Kerber RE, Adams HP (1991) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1822968 Ischemic cerebrovascular complications and risk factors in idiopathic hypertrophic subaortic stenosis.] ''Stroke'' 22 (9):1143-7. PMID: [http://pubmed.gov/1822968 1822968]</ref><ref name="pmid7666571">Shigematsu Y, Hamada M, Mukai M, Matsuoka H, Sumimoto T, Hiwada K (1995) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7666571 Mechanism of atrial fibrillation and increased incidence of thromboembolism in patients with hypertrophic cardiomyopathy.] ''Jpn Circ J'' 59 (6):329-36. PMID: [http://pubmed.gov/7666571 7666571]</ref>  


==2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial                    Fibrillation (DO NOT EDIT)<ref name="pmid21392637">{{cite journal| author=Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al.| title=2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2011 | volume= 57 | issue= 11 | pages= e101-98 | pmid=21392637 | doi=10.1016/j.jacc.2010.09.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21392637  }} </ref>==
==2011 ACCF/AHA/HRS Focused Updates Incorporated into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial                    Fibrillation (DO NOT EDIT)<ref name="pmid21392637">{{cite journal| author=Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al.| title=2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2011 | volume= 57 | issue= 11 | pages= e101-98 | pmid=21392637 | doi=10.1016/j.jacc.2010.09.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21392637  }} </ref>==
===Hyperthyroidism (DO NOT EDIT) <ref name="pmid21392637">{{cite journal| author=Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al.| title=2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2011 | volume= 57 | issue= 11 | pages= e101-98 | pmid=21392637 | doi=10.1016/j.jacc.2010.09.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21392637  }} </ref>===
===Hyperthyroidism (DO NOT EDIT) <ref name="pmid21392637">{{cite journal| author=Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al.| title=2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2011 | volume= 57 | issue= 11 | pages= e101-98 | pmid=21392637 | doi=10.1016/j.jacc.2010.09.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21392637  }} </ref>===


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==Vote on and Suggest Revisions to the Current Guidelines==
==Related Chapters==
* [[The Living Guidelines: Diagnosis and Management of Atrial Fibrillation | The AF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
* [[The Living Guidelines: Diagnosis and Management of Atrial Fibrillation | The AF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]


==Guideline Resources==
==Sources==
*[http://content.onlinejacc.org/cgi/reprint/48/4/e149.pdf ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation] <ref name="pmid16908781">Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16908781 ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.] ''Circulation'' 114 (7):e257-354. [http://dx.doi.org/10.1161/CIRCULATIONAHA.106.177292 DOI:10.1161/CIRCULATIONAHA.106.177292] PMID: [http://pubmed.gov/16908781 16908781]</ref>
*[http://content.onlinejacc.org/cgi/reprint/48/4/e149.pdf ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation] <ref name="pmid16908781">Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16908781 ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.] ''Circulation'' 114 (7):e257-354. [http://dx.doi.org/10.1161/CIRCULATIONAHA.106.177292 DOI:10.1161/CIRCULATIONAHA.106.177292] PMID: [http://pubmed.gov/16908781 16908781]</ref>


Revision as of 15:04, 6 November 2012

Conduction
Sinus rhythm
Atrial fibrillation
'
ICD-10 I48
ICD-9 427.31
DiseasesDB 1065
MedlinePlus 000184

Atrial Fibrillation Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Atrial Fibrillation from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Special Groups

Postoperative AF
Acute Myocardial Infarction
Wolff-Parkinson-White Preexcitation Syndrome
Hypertrophic Cardiomyopathy
Hyperthyroidism
Pulmonary Diseases
Pregnancy
ACS and/or PCI or valve intervention
Heart failure

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples
A-Fib with LBBB

Chest X Ray

Echocardiography

Holter Monitoring and Exercise Stress Testing

Cardiac MRI

Treatment

Rate and Rhythm Control

Cardioversion

Overview
Electrical Cardioversion
Pharmacological Cardioversion

Anticoagulation

Overview
Warfarin
Converting from or to Warfarin
Converting from or to Parenteral Anticoagulants
Dabigatran

Maintenance of Sinus Rhythm

Surgery

Catheter Ablation
AV Nodal Ablation
Surgical Ablation
Cardiac Surgery

Specific Patient Groups

Primary Prevention

Secondary Prevention

Supportive Trial Data

Cost-Effectiveness of Therapy

Case Studies

Case #1

Atrial fibrillation hyperthyroidism On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Atrial fibrillation hyperthyroidism

CDC on Atrial fibrillation hyperthyroidism

Atrial fibrillation hyperthyroidism in the news

Blogs on Atrial fibrillation hyperthyroidism

Directions to Hospitals Treating Atrial fibrillation hyperthyroidism

Risk calculators and risk factors for Atrial fibrillation hyperthyroidism

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.

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.[1] In patients with hyperthyroidism, oral anticoagulation may be recommended to prevent systemic embolism.[2] AF in the setting of thyrotoxicosis has been shown to be associated with decompensated heart failure.[3][4][5]

2011 ACCF/AHA/HRS Focused Updates Incorporated into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation (DO NOT EDIT)[6]

Hyperthyroidism (DO NOT EDIT) [6]

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 nondihydropyridine 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)"

Related Chapters

Sources

References

  1. ↑ Clozel JP, Danchin N, Genton P, Thomas JL, Cherrier F (1984) Effects of propranolol and of verapamil on heart rate and blood pressure in hyperthyroidism. Clin Pharmacol Ther 36 (1):64-9. PMID: 6734051
  2. ↑ Hirsh J (1991) Oral anticoagulant drugs. N Engl J Med 324 (26):1865-75. DOI:10.1056/NEJM199106273242606 PMID: 1801769
  3. ↑ Robinson K, Frenneaux MP, Stockins B, Karatasakis G, Poloniecki JD, McKenna WJ (1990) Atrial fibrillation in hypertrophic cardiomyopathy: a longitudinal study. J Am Coll Cardiol 15 (6):1279-85. PMID: 2329232
  4. ↑ Russell JW, Biller J, Hajduczok ZD, Jones MP, Kerber RE, Adams HP (1991) Ischemic cerebrovascular complications and risk factors in idiopathic hypertrophic subaortic stenosis. Stroke 22 (9):1143-7. PMID: 1822968
  5. ↑ Shigematsu Y, Hamada M, Mukai M, Matsuoka H, Sumimoto T, Hiwada K (1995) Mechanism of atrial fibrillation and increased incidence of thromboembolism in patients with hypertrophic cardiomyopathy. Jpn Circ J 59 (6):329-36. PMID: 7666571
  6. ↑ 6.0 6.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA; et al. (2011). "2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". J Am Coll Cardiol. 57 (11): e101–98. doi:10.1016/j.jacc.2010.09.013. PMID 21392637.
  7. ↑ Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114 (7):e257-354. DOI:10.1161/CIRCULATIONAHA.106.177292 PMID: 16908781
  8. ↑ Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2011) 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 123 (10):e269-367. DOI:10.1161/CIR.0b013e318214876d PMID: 21382897
  9. ↑ Estes NA, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS et al. (2008) ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation): developed in collaboration with the Heart Rhythm Society. Circulation 117 (8):1101-20. DOI:10.1161/CIRCULATIONAHA.107.187192 PMID: 18283199

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