Marrakchi S, Kanoun F, Idriss S, Kammoun I, Kachboura S
Abderrahmane Mami hospital, Tunis, Tunisia,
Herz. 2015 Apr;40 Suppl 2:101-9. doi: 10.1007/s00059-014-4123-0. Epub 2014 Jul 4.
Arrhythmia is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of arrhythmia in patients with overt and subclinical thyroid disease and discuss the management of this arrhythmia.
A literature search was carried out for reports published with the following terms: thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinase, atrial flutter, supraventricular arrhythmia, ventricular arrhythmia, ventricular tachycardia, ventricular fibrillation, torsade de pointes, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English.
The outcome of this analysis suggests that patients with untreated overt clinical or subclinical thyroid dysfunction are at increased risk of arrhythmia. Hyperthyroidism increased atrial arrhythmia; however, hypothyroidism increased ventricular arrhythmia.
The early recognition and effective treatment of thyroid dysfunction in patients with arrhythmia is mandatory because the long-term prognosis of arrhythmia may be improved with the appropriate treatment of thyroid dysfunction.
心律失常是欧洲和美国发病和死亡的主要原因。这篇综述文章的目的是评估前瞻性研究的结果，这些研究评估了显性和亚临床甲状腺疾病患者的心律失常风险，并讨论这种心律失常的管理。
对以下术语发表的报告进行了文献检索：甲状腺、甲状腺功能减退、甲状腺功能亢进、亚临床甲状腺功能亢进、亚临床甲状腺功能减退、左甲状腺素、三碘甲状腺原氨酸、抗甲状腺药物、放射性碘、脱碘酶、心房扑动、室上性心律失常、室性心律失常、室性心动过速、心室颤动、尖端扭转型室速、胺碘酮和心房颤动。调查仅限于用英文发表的报告。
该分析结果表明，未经治疗的显性临床或亚临床甲状腺功能障碍患者发生心律失常的风险增加。甲状腺功能亢进增加心房心律失常；然而，甲状腺功能减退增加室性心律失常。
对于心律失常患者，必须尽早识别并有效治疗甲状腺功能障碍，因为通过适当治疗甲状腺功能障碍，心律失常的长期预后可能会得到改善。
