Maimone Sergio, Filomia Roberto, Saitta Carlo, Raimondo Giovanni, Squadrito Giovanni
From Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy (SM, RF, CS, GR, GS); Department of Internal Medicine, University Hospital of Messina, Messina, Italy (GR); and Department of Human Pathology, University Hospital of Messina, Messina, Italy (GS).
Medicine (Baltimore). 2015 Sep;94(35):e1406. doi: 10.1097/MD.0000000000001406.
We describe the case of a 73-year-old woman with liver cirrhosis and hepatocellular carcinoma (HCC) who developed 2 distinct episodes of paroxystic atrial fibrillation (AF) each of which occurred 1 to 4 hours after iodine medium contrast-enhanced computed tomography. Sinus rhythm was restored by amiodarone therapy after the first AF episode and by electrical cardioversion after the second one. A careful clinical, biochemical, and instrumental examination showed that the patient had subclinical hyperthyroidism and moderate mitral insufficiency with mild atrial enlargement.Thus, the coexistence of both subclinical disthyroidism and of cardiac anatomical alterations may have predisposed the patient to AF that in fact occurred when exogenous iodine administration triggered a hyperthyroidism status.
我们描述了一名73岁患有肝硬化和肝细胞癌（HCC）的女性病例，她出现了2次不同的阵发性心房颤动（AF）发作，每次发作均在碘造影剂增强计算机断层扫描后1至4小时发生。第一次房颤发作后，胺碘酮治疗恢复了窦性心律，第二次发作后通过电复律恢复了窦性心律。仔细的临床、生化和仪器检查表明，该患者患有亚临床甲状腺功能亢进和中度二尖瓣关闭不全伴轻度心房扩大。因此，亚临床甲状腺功能减退和心脏解剖结构改变的并存可能使患者易患房颤，而事实上，外源性碘给药引发甲状腺功能亢进状态时房颤发生了。
