Influence of thyroid-stimulating hormone on the recurrence after radiofrequency ablation for atrial fibrillation

Abstract

Atrial fibrillation is one of the most common sustained disorders of cardiac rhythm and is associated with an increased risk of mortality, morbidity due to thromboembolic complications, and heart failure. It is important to highlight that the causative factors are vast. It is well-known that thyroid dysfunction has a proarrhythmic effect and increases the risk of cardiovascular disease. Hyperthyroidism or thyrotoxicosis is recognized to be a baseline risk factor for the development of atrial fibrillation. However, the role of hypothyroidism in atrial arrhythmogenesis is less recognized and not fully understood. At the moment radiofrequency catheter ablation is actively used in the treatment of atrial fibrillation, which in most cases has high efficiency and persistent effect. Despite that, the recurrence of supraventricular tachyarrhythmia can be observed in some patients even after radiofrequency cathe­ter ablation. Patients with a history of hypothyroidism or even high-normal thyroid-stimulating hormone levels are more likely to have a recurrence of supraventricular tachyarrhythmia after radiofrequency catheter ablation. Therefore, thyroid-stimulating hormone levels should be determined in patients who have undergone radiofrequency catheter ablation of atrial fibrillation, especially paroxysmal atrial fibrillation. Consequently, it should be noted that the assessment and correction of modifying risk factors before radiofrequency catheter ablation may provide opportunities for future prevention of recurrence of supraventricular paroxysmal arrhythmias, improve the prognosis and overall quality of life in patients of this group. We have demonstrated the clinical case and emphasized the association of high-normal thyroid-stimulating hormone levels with supraventricular tachyarrhythmia recurrence after radiofrequency catheter ablation for atrial fibrillation.