What is the prognosis of amiodarone-associated thyroid dysfunction?

Updated: Aug 28, 2020
  • Author: Mini Gopalan, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

The prognosis for AIT may be very poor even though a wide range of antithyroid therapy is available. This prognosis emphasizes the need for careful monitoring of patients receiving amiodarone treatment.

The long-term prognosis for AIH is usually good.

A randomized, double-blind study by Diederichsen et al indicated that in patients without previous thyroid dysfunction, short-term amiodarone use can be safe. The study looked at the effects of 8 weeks of either amiodarone or placebo therapy in 212 patients with atrial fibrillation undergoing catheter ablation. Although the amiodarone patients had higher levels of TSH, T4, and free T4, as well as lower levels of T3 and free T3, than did the placebo group, thyroid dysfunction peaked at 1 month, was declining at 3 months, and returned to baseline levels by 6 months. [8]

A study by Wang et al indicated that in patients with paroxysmal atrial fibrillation and AIT, early catheter ablation is safe and effective, although the rate of atrial tachyarrhythmia recurrence is higher than in controls for as long as 3 months after pulmonary vein isolation. [9]


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