title: Predictors of Atrial Fibrillation Recurrence in Hyperthyroid and Euthyroid Patients.
abstract: BACKGROUND
  Atrial fibrillation (AF) is the most common arrhythmia in adults, and is encountered in 10-15% of the patients with hyperthyroidism. Unless euthyroidism is restored, pharmacological or electrical cardioversion is controversial in patients with AF who remain hyperthyroid.
  
  
  OBJECTIVE
  The aim of this study was to assess the efficacy of electrical cardioversion and predictors of AF recurrence in hyperthyroid and euthyroid patients.
  
  
  METHODS
  The study included 33 hyperthyroid (21 males) and 48 euthyroid (17 males) patients with persistent AF. The patients were sedated with intravenous midazolam before undergoing electrical cardioversion delivered by synchronized biphasic shocks. Rates of AF recurrence were recorded.
  
  
  RESULTS
  Mean follow-up was 23.63 ± 3.74 months in the hyperthyroid group and 22.78 ± 3.15 months in the euthyroid group (p = 0.51). AF recurred in 14 (43.8%) and 21 (44.7%) patients in each group, respectively (p = 0.93). Multivariate regression analysis in each group showed that AF duration was the only predictor of AF recurrence, with odds ratios of 1.38 (95% confidence interval [CI] = 1.05 - 1.82, p = 0.02) in the hyperthyroid group and 1.42 (95% CI = 1.05 - 1.91, p= 0.02) in the euthyroid group.
  
  
  CONCLUSIONS
  Rates of long-term AF recurrence were similar in successfully cardioverted hyperthyroid and euthyroid patients. The only predictor of AF recurrence in both groups was AF duration.
authors.affiliation: Department of Cardiology, Edirne State Hospital, Edirne, Turkey.
authors.forename: Muhammet
authors.initials: M
authors.lastname: Gürdoğan
authors.affiliation: Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ari
authors.affiliation: Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Tenekecioğlu
authors.affiliation: Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey.
authors.forename: Selma
authors.initials: S
authors.lastname: Ari
authors.affiliation: Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey.
authors.forename: Tahsin
authors.initials: T
authors.lastname: Bozat
authors.affiliation: Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Koca
authors.affiliation: Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Melek
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D004554:Electric Countershock / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
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