FREQUENCY OF HYPERTHYROIDISM IN PATIENTS PRESENTING WITH ATRIAL FIBRILLATION
DOI:
https://doi.org/10.54112/pjicm.v5i02.153Keywords:
Atrial Fibrillation, Hyperthyroidism, Thyroid-Stimulating Hormone, ComorbidityAbstract
Background: Hyperthyroidism is a recognized secondary cause of atrial fibrillation (AF) and contributes to increased morbidity. Early identification is essential for timely management. Objective: To determine the frequency of hyperthyroidism in patients presenting with atrial fibrillation and its associated factors. Study Design: Cross-sectional study. Setting: Department of Cardiology, Khyber Teaching Hospital, Peshawar, Pakistan. Duration of Study: From 07-February-2025 to 07-June-2025. Methods: A total of 260 patients with ECG-confirmed AF were enrolled. Diagnosis of hyperthyroidism was based on clinical features (weight loss, palpitations, tremors) and laboratory analysis (serum TSH <0.5 mIU/L with either free T3 >450 pg/dL or free T4 >1.8 ng/dL). Data on demographics, BMI, and comorbidities were collected. Statistical analysis was performed using SPSS; p-values <0.05 were considered significant. Results: The mean age was 51.05 ± 12.38 years, with 135 males (51.9%) and 125 females (48.1%). Hyperthyroidism was identified in 22 patients (8.5%). Female gender (p = 0.04) and presence of comorbidities (p = 0.003) were significantly associated with hyperthyroidism, while age and BMI showed no significant association. Conclusion: Hyperthyroidism was present in 8.5% of patients with AF, showing a significant association with female gender and comorbid conditions. Routine thyroid function screening is recommended in AF patients, particularly in females and those with comorbidities.
References
Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights. Circ Res. 2020;127(1):4–20. https://doi.org/10.1161/CIRCRESAHA.120.316340
Elliott AD, Middeldorp ME, Van Gelder IC, Albert CM, Sanders P. Epidemiology and modifiable risk factors for atrial fibrillation. Nat Rev Cardiol. 2023;20(6):404–17. https://doi.org/10.1038/s41569-022-00820-8
Guichard JB, Xiong F, Qi XY, L’Heureux N, Hiram R, Xiao J, et al. Role of atrial arrhythmia and ventricular response in atrial fibrillation induced atrial remodelling. Cardiovasc Res. 2021;117(2):462–71. https://doi.org/10.1093/cvr/cvaa007
Erhard N, Metzner A, Fink T. Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications. Herzschrittmachertherapie+ Elektrophysiologie. 2022;33(1):71–6. https://doi.org/10.1007/s00399-021-00836-6
Markides V, Schilling RJ. Atrial fibrillation: classification, pathophysiology, mechanisms and drug treatment. Heart. 2003;89(8):939–43. https://doi.org/10.1136/heart.89.8.939
Amin A, Houmsse A, Ishola A, Tyler J, Houmsse M. The current approach of atrial fibrillation management. Avicenna J Med. 2016;6(1):8–16. https://doi.org/10.4103/2231-0770.173580
McManus DD, Rienstra M, Benjamin EJ. An update on the prognosis of patients with atrial fibrillation. Circulation. 2012;126(10):e143–6. https://doi.org/10.1161/CIRCULATIONAHA.112.129759
Taylor PN, Albrecht D, Scholz A. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 2018;14(5):301–16. https://doi.org/10.1038/nrendo.2018.18
Chung JH. Update on thyroid hormone levels and thyroid dysfunction in the Korean population based on data from the Korea National Health and Nutrition Examination Survey VI. Endocrinol Metab. 2020;35(1):7–13. https://doi.org/10.3803/EnM.2020.35.1.7
Ross DS, Burch HB, Cooper DS. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016;26(10):1343–421. https://doi.org/10.1089/thy.2016.0229
Wiersinga WM, Poppe KG, Effraimidis G. Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis. Lancet Diabetes Endocrinol. 2023;11(4):282–98. https://doi.org/10.1016/S2213-8587(23)00005-0
Bereda G. Hyperthyroidism: definition, causes, pathophysiology and management. J Biomed Biol Sci. 2022;1(2):1–11.
Heeringa J, Hoogendoorn EH, van der Deure WM, Hofman A, Peeters RP, Hop WC, et al. High-normal thyroid function and risk of atrial fibrillation: the Rotterdam study. Arch Intern Med. 2008;168(20):2219–24. https://doi.org/10.1001/archinte.168.20.2219
Bakarmom MK, Al.muhanna AN, Alhussaini SA, Alghamdi A, Suliman I. The prevalence of hyperthyroidism amongst atrial fibrillation patients in the National Guard Hospital, Riyadh, Saudi Arabia: a cross-sectional retrospective study. Cureus. 2023;15(10):e46791. https://doi.org/10.7759/cureus.46791
Ullah S, Ahmad A, Akhtar S, Shah SS, Ashraf A. Frequency of hyperthyroidism in patients presenting with atrial fibrillation to cardiology unit Khyber Teaching Hospital Peshawar. Pak Heart J. 2022;55(Suppl 1):S9. https://doi.org/10.47144/phj.v55iSupplement1.2425
Hussain S, Nawaz T, Hayat FS, Amin M, Shaharyar U. Frequency of hyperthyroidism in patients diagnosed with atrial fibrillation. Pak J Health Sci. 2025;6(7):70–4. https://doi.org/10.54393/pjhs.v6i7.2778
Tefera EM, Tefera YM, Yimer M, Worku BM, Ayele E, Asmare BZ, et al. Atrial fibrillation and associated factors among hyperthyroidism patients attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Clin Med Insights Endocrinol Diabetes. 2024;17:11795514241285347. https://doi.org/10.1177/11795514241285347
Hytting J, Celik S, Bodeström Eriksson L, Mallios P, Digerfeldt C, Waldemar A, et al. Prevalence of abnormal thyroid hormone levels in acute new-onset atrial fibrillation. Front Cardiovasc Med. 2025;11:1518297. https://doi.org/10.3389/fcvm.2024.1518297
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 I KHAN , A ASHRAF , Q ULLAH, N SULTAN

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.