Algorithm of management of patients treated with amiodarone depending on thyroid functional state

Abstract

Cardiac arrhythmias are common symptoms of various cardiovascular diseases. Currently, amiodarone is considered to be one of the most efficient and safe antiarrhythmic drugs. Long-term use of amiodarone having the chemical structure similar to that of thyroxine can cause disturbances in the functional state of the thyroid gland. 32 (6.9 percent) of the 462 patients who used the drug for more than six months developed amiodarone-associated thyrotoxicosis and 11 (2,5%) one amiodarone-associated hypothyroidism. Most patients with hyperthyroidism, 22 (68,8%), did not have any structural pathology of the thyroid gland, 8 (25%) presented with CKD euthyroid goiter and 2 (6.2%) with chronic autoimmune thyroiditis. The authors propose a modified algorithm of preventive measures for patients with rhythm disorders receiving long-term amiodarone. Assessment of basal metabolism and the structure of the thyroid gland before and during therapy will allow to adequately monitor adverse events and carry out the necessary corrective treatment.