Document Detail


Radioiodine ablation of the thyroid to prevent recurrence of amiodarone-induced thyrotoxicosis in patients with resistant tachyarrhythmias.
MedLine Citation:
PMID:  15018878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Amiodarone-induced thyrotoxicosis (AIT) is a common complication of amiodarone therapy. Although permanent withdrawal of amiodarone is recommended due notably to the risk of worsening of tachyarrhythmias, some patients may require the reintroduction of amiodarone several months after normalizing their thyroid function. We, retrospectively, assessed the effects of (131)I therapy to prevent recurrence of AIT in euthyroid patients requiring reintroduction of amiodarone. SUBJECTS AND METHODS: Amiodarone was required in 10 cases of recurrent symptomatic paroxysmal atrial fibrillation (AF) and in 5 cases of ventricular tachycardia (VT) (M = 12, F = 3, mean age: 63 +/- 14). The underlying heart disease was dilated cardiomyopathy (n = 4), ischaemic heart disease (n = 4), hypertensive heart disease (n = 2), arrhythmogenic right ventricular dysplasia (n = 27) and valvulopathy (n = 1). Two patients had idiopathic paroxysmal AF. RESULTS: A mean (131)I dose of 579 +/- 183 MBq was administered 34 +/- 37 after the episode of AIT. Amiodarone was reintroduced in 14 of 15 patients after a mean interval of 103 +/- 261 d. Fourteen patients developed definite hypothyroidism necessitating l-thyroxine but we observed no late recurrence of AIT. After a mean follow-up of 22 +/- 16 months, tachyarrhythmias were controlled in 12 of 14 patients. CONCLUSION: (131)I therapy appears to be an effective and safe approach to prevent the recurrence of AIT in a patient requiring the reintroduction of amiodarone for tachyarrhythmias.
Authors:
Jean-Sylvain Hermida; Emmanuel Tcheng; Genevieve Jarry; Veronique Moullart; Sylvie Arlot; Jean-Luc Rey; Jean Delonca; Claire Schvartz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  6     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-15     Completed Date:  2004-06-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  169-74     Citation Subset:  IM    
Affiliation:
Cardiology Department, Hôpital Sud, Centre Hospitalier Universitaire, University Hospital, 80054 Amiens Cedex, France.
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MeSH Terms
Descriptor/Qualifier:
Amiodarone / adverse effects*,  therapeutic use*
Anti-Arrhythmia Agents / adverse effects*,  therapeutic use*
Atrial Fibrillation / drug therapy*
Female
Humans
Iodine Radioisotopes / therapeutic use*
Male
Middle Aged
Recurrence
Risk
Tachycardia, Ventricular / drug therapy*
Thyroid Gland / radiation effects*
Thyrotoxicosis / chemically induced*,  prevention & control*
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Iodine Radioisotopes; 1951-25-3/Amiodarone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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