Abstract
BackgroundHypothyroidism can be a cause of sinus bradycardia. However, thyroid laboratory evaluation is often performed routinely in patients with complete heart block (CHB) though there is little data to support this practice. This study aimed to assess the frequency of thyroid dysfunction in patients presenting with CHB without clinical features of hypothyroidism.MethodologyAll patients referred for permanent pacemaker implantation for CHB were included in this cross-sectional study. Patients with known thyroid disorder or clinical features of thyroid disorder were excluded. Demographic, electrocardiography (EKG), and routine thyroid stimulating hormone (TSH) screening results were recorded.ResultsA total of 102 patients with complete atrioventricular (AV) block were enrolled in the study of which 50.0% (51) were male. The mean age was 61.09 ± 11.74. Co-morbidities included diabetes mellitus 44.1% (45), smoking 36.3% (37), and hypertension 55.9% (57). Mean EKG atrial rate was 82.97 ± 31.31 mmHg with a mean ventricular escape rate of 36.17 ± 5.93. Permanent pacemakers were implanted in all of the patients. Only one patient had an abnormal TSH.ConclusionsWe found a very low prevalence of thyroid dysfunction among patients without clinical features of thyroid dysfunction presenting with third-degree AV block. This calls for cautious prescription of thyroid testing in clinically euthyroid patients.
Highlights
We found a very low prevalence of thyroid dysfunction among patients without clinical features of thyroid dysfunction presenting with third-degree AV block
This calls for cautious prescription of thyroid testing in clinically euthyroid patients
Sinus bradycardia is a well-known manifestation of hypothyroidism, there is a paucity of data to suggest a direct relationship of atrioventricular (AV) block with hypothyroidism
Summary
Sinus bradycardia is a well-known manifestation of hypothyroidism, there is a paucity of data to suggest a direct relationship of atrioventricular (AV) block with hypothyroidism. Thyroid hormone affects the cardiovascular system through direct or indirect mechanisms. Limited case reports of patients with known thyroid abnormality and presenting with AV block have been published. There are no data to suggest that there is a benefit of routinely assessing thyroid status in clinically euthyroid patients with complete heart block (CHB). Hypothyroidism can be a cause of sinus bradycardia. Thyroid laboratory evaluation is often performed routinely in patients with complete heart block (CHB) though there is little data to support this practice. This study aimed to assess the frequency of thyroid dysfunction in patients presenting with CHB without clinical features of hypothyroidism
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