TY - JOUR

T1 - Short-term amiodarone treatment for atrial fibrillation after catheter ablation induces a transient thyroid dysfunction

T2 - Results from the placebo-controlled, randomized AMIO-CAT trial

AU - Diederichsen, Søren Zöga

AU - Darkner, Stine

AU - Chen, Xu

AU - Johannesen, Arne

AU - Pehrson, Steen

AU - Hansen, Jim

AU - Feldt-Rasmussen, Ulla

AU - Svendsen, Jesper Hastrup

N1 - Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

PY - 2016/9

Y1 - 2016/9

N2 - BACKGROUND: Amiodarone is known to affect the thyroid, but little is known about thyroid recovery after short-term amiodarone treatment.OBJECTIVES: We aimed to evaluate the impact of 8weeks of amiodarone treatment on thyroid function in patients with atrial fibrillation (AF) undergoing catheter ablation in a randomised, double-blind clinical trial.METHODS: 212 patients referred for AF ablation at two centres were randomized to 8weeks of oral amiodarone or placebo. Thyroid function tests (TSH, thyroid stimulating hormone; T4, thyroxine; T3, triiodothyronine; fT4, free T4; fT3, free T3) were performed at baseline and 1, 3 and 6months.RESULTS: Study drug was discontinued due to mild thyroid dysfunction in 1 patient in the placebo vs. 3 in the amiodarone group (p=0.6). In linear mixed models there were significant effects of amiodarone on thyroid function tests, modified by follow-up visit (p<10(-9) for both TSH, T4, T3, fT4 and fT3). The amiodarone group had higher TSH, fT4 and T4 after 1 and 3months compared to placebo, whereas T3 and fT3 were lower. In all cases, the amiodarone-induced thyroid dysfunction was largest at 1month, declining at 3months, and with no differences at 6months, compared to baseline.CONCLUSION: We found amiodarone to have a significant impact on thyroid function after only 1month, but with a fast recovery of thyroid function after amiodarone discontinuation. Our study indicates that short-term amiodarone can be considered safe in patients without prior thyroid dysfunction.

AB - BACKGROUND: Amiodarone is known to affect the thyroid, but little is known about thyroid recovery after short-term amiodarone treatment.OBJECTIVES: We aimed to evaluate the impact of 8weeks of amiodarone treatment on thyroid function in patients with atrial fibrillation (AF) undergoing catheter ablation in a randomised, double-blind clinical trial.METHODS: 212 patients referred for AF ablation at two centres were randomized to 8weeks of oral amiodarone or placebo. Thyroid function tests (TSH, thyroid stimulating hormone; T4, thyroxine; T3, triiodothyronine; fT4, free T4; fT3, free T3) were performed at baseline and 1, 3 and 6months.RESULTS: Study drug was discontinued due to mild thyroid dysfunction in 1 patient in the placebo vs. 3 in the amiodarone group (p=0.6). In linear mixed models there were significant effects of amiodarone on thyroid function tests, modified by follow-up visit (p<10(-9) for both TSH, T4, T3, fT4 and fT3). The amiodarone group had higher TSH, fT4 and T4 after 1 and 3months compared to placebo, whereas T3 and fT3 were lower. In all cases, the amiodarone-induced thyroid dysfunction was largest at 1month, declining at 3months, and with no differences at 6months, compared to baseline.CONCLUSION: We found amiodarone to have a significant impact on thyroid function after only 1month, but with a fast recovery of thyroid function after amiodarone discontinuation. Our study indicates that short-term amiodarone can be considered safe in patients without prior thyroid dysfunction.

KW - Journal Article

U2 - 10.1016/j.ejim.2016.04.012

DO - 10.1016/j.ejim.2016.04.012

M3 - Journal article

C2 - 27129624

VL - 33

SP - 36

EP - 41

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

ER -