Amiodarone-related thyroid dysfunction.

Abstract

Nowadays, amiodarone is the most commonly used antidysrhythmic drug in clinical practice. It is highly effective in the management of recurrent ventricular dysrhythmias, paroxysmal supraventricular dysrhythmias, including atrial fibrillation and flutter, and in the maintenance of sinus rhythm after electrical cardioversion of atrial fibrillation. Moreover, it has the added benefit of being well tolerated in patients with both normal and impaired left ventricular systolic function. Despite amiodarone's potent antidysrhythmic actions, its use is hampered by numerous adverse effects on various organs, including the thyroid. Adverse effects are becoming more prevalent given the increasing incidence of dysrhythmias and wider amiodarone use. Thus, physicians and patients should both be aware of the potential thyroid-specific sequelae. However, amiodarone is likely to remain a significant problem for endocrinologists as concerns exist over the use of the new alternative antiarrhythmic agent, dronedarone, especially in patients with heart failure and left ventricular dysfunction because of the risk of hepatic injury and increased mortality. The final diagnostic and therapeutic approaches must be discussed among the patient, the general practitioner, the cardiologist, and the endocrinologist.

• Authors: Bartosz Hudzik, Barbara Zubelewicz-Szkodzinska
• Journal: Internal and emergency medicine (Intern Emerg Med) Vol. 9 Issue 8 Pg. 829-39 (Dec 2014) ISSN: 1970-9366 [Electronic] Italy
• PMID: 25348560 (Publication Type: Journal Article)

Chemical References

• Anti-Arrhythmia Agents
• Amiodarone

Topics

• Amiodarone (adverse effects, therapeutic use)
• Anti-Arrhythmia Agents (adverse effects, therapeutic use)
• Atrial Fibrillation (drug therapy)
• Heart Failure (drug therapy)
• Humans
• Hypothyroidism (complications, diagnosis)
• Thyroid Gland (abnormalities, drug effects)
• Thyrotoxicosis (complications, diagnosis)