Nakazawa H K, Sakurai K, Hamada N, Momotani N, Ito K
Am J Med. 1982 Jun;72(6):903-6. doi: 10.1016/0002-9343(82)90850-6.
This study was designed to investigate the appropriate timing for cardioversion in patients with chronic atrial fibrillation who had been rendered euthyroid from a thyrotoxic state. We carried out a retrospective study of 163 patients with thyrotoxic atrial fibrillation, with a mean follow-up of 34 months. With control of thyroid function alone, 101 patients had spontaneous reversion of atrial fibrillation to sinus rhythm and 62 patients had persistent atrial fibrillation. In those with spontaneous reversion, the longest duration of atrial fibrillation prior to the euthyroid state was 13 months. In those with persistent fibrillation, the shortest duration of atrial fibrillation prior to the euthyroid state was eight months. Almost three-quarters of those with spontaneous reversion had conversion to sinus rhythm within three weeks of becoming euthyroid. No spontaneous reversion occurred if atrial fibrillation was still present after the patients had been in a euthyroid state for four months. This study suggests that spontaneous reversion of atrial fibrillation to sinus rhythm is highly unlikely if the duration of atrial fibrillation before the euthyroid state is achieved exceeds 13 months, or if it is still present after the patient has been in a euthyroid state for four months, Cardioversion should be performed at about the 16th week after the euthyroid state is achieved.
本研究旨在调查甲状腺功能从甲状腺毒症状态恢复正常的慢性心房颤动患者进行心脏复律的合适时机。我们对163例甲状腺毒症性心房颤动患者进行了一项回顾性研究，平均随访34个月。仅通过控制甲状腺功能，101例患者的心房颤动自发恢复为窦性心律，62例患者持续存在心房颤动。在自发恢复的患者中，甲状腺功能正常状态之前心房颤动的最长持续时间为13个月。在持续心房颤动的患者中，甲状腺功能正常状态之前心房颤动的最短持续时间为8个月。几乎四分之三的自发恢复患者在甲状腺功能恢复正常后的三周内恢复为窦性心律。如果患者在甲状腺功能恢复正常状态四个月后仍存在心房颤动，则不会发生自发恢复。本研究表明，如果在达到甲状腺功能正常状态之前心房颤动的持续时间超过13个月，或者在患者处于甲状腺功能正常状态四个月后仍存在心房颤动，则心房颤动自发恢复为窦性心律的可能性极小。应在达到甲状腺功能正常状态后的第16周左右进行心脏复律。
