title: Graves' disease complicated by ventricular fibrillation in three men who were smokers.
abstract: BACKGROUND
  Thyrotoxicosis is known to be associated with sinus tachycardia and supraventricular tachyarrhythmias, but rarely with ventricular fibrillation (Vf), which has only occurred in some patients with hypokalemic periodic paralysis or ischemic heart disease.
  
  
  METHODS
  We present three men who were transferred to our hospital with Graves' disease who developed idiopathic Vf. None of them had hypokalemic periodic paralysis or ischemic heart disease but all were smokers. None of other patients with thyrotoxicosis (587 females and 155 males) who were seen at our hospital, in the period during which the three men were seen, had idiopathic Vf. In our three men with thyrotoxicosis and idiopathic Vf, there was no identifiable underlying heart disease. One of the three patients died of hypoxic encephalopathy. The other two men did not have recurrent Vf after their thyroid function normalized.
  
  
  CONCLUSIONS
  These cases and a review of similar cases in the literature imply that improving thyrotoxicosis seems to be effective for treating idiopathic Vf in some patients.
  
  
  CONCLUSIONS
  Our findings suggest that thyroid hormone excess might play a direct role in the development of Vf in susceptible individuals. Our experience with these three patients suggests that smoking men with thyrotoxicosis likely have an increased risk for Vf, even if they do not have other predisposing factors.
authors.affiliation: Department of Endocrinology and Metabolism, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. takaoando@gmail.com
authors.forename: Takao
authors.initials: T
authors.lastname: Ando
authors.forename: Tomoko
authors.initials: T
authors.lastname: Henmi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Haruta
authors.forename: Ai
authors.initials: A
authors.lastname: Haraguchi
authors.forename: Ikuko
authors.initials: I
authors.lastname: Ueki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Horie
authors.forename: Misa
authors.initials: M
authors.lastname: Imaizumi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Usa
authors.forename: Kouji
authors.initials: K
authors.lastname: Maemura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D013960:Thyroid Function Tests; D013971:Thyrotoxicosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
chemical_list: D013956:Antithyroid Agents