open access

Vol 65, No 4 (2014)
Original papers
Published online: 2014-08-29
Submitted: 2014-08-29
Accepted: 2014-08-29
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Results of preventive radioiodine therapy in euthyroid patients with history of hyperthyroidism prior to administration of amiodarone with permanent atrial fibrillation — a preliminary study

Agata Czarnywojtek, Małgorzata Zgorzalewicz-Stachowiak, Kosma Woliński, Maria Teresa Płazińska, Izabela Miechowicz, Barbara Kwiecińska, Rafał Czepczyński, Leszek Królicki, Marek Ruchała
DOI: 10.5603/EP.2014.0036
·
Endokrynologia Polska 2014;65(4):269-274.

open access

Vol 65, No 4 (2014)
Original papers
Published online: 2014-08-29
Submitted: 2014-08-29
Accepted: 2014-08-29

Abstract

Introduction: Radioiodine (RAI) therapy is a standard procedure in the treatment of hyperthyroidism. However, the use of RAI in euthyroid patients requiring chronic administration of amiodarone (AM) where other antiarrhythmic drugs may lack efficacy is still controversial.

Objective: The aim of this study was to assess the safety and efficacy of an AM therapy prior to treatment with radioiodine therapy in euthyroid patients with permanent atrial fibrillation (PAF), who had been treated for hyperthyroidism in the past.

Material and methods: This was a retrospective observational study. Patients were assessed at baseline and two, six, eight, and 12 months after RAI therapy. 17 euthyroid patients with PAF were qualified to the RAI (female/male 3/14; age range 65 to 87, median 71). The patients required chronic administration of AM as a prophylaxis against sudden death.

Results: Each patient received an ablative dose of 800 MBq (22 mCi) of 131I. At baseline and during follow-up, no side effects of the therapy and no signs of drug intolerance were observed. Subclinical hyperthyroidism occurred in two (11.8%) cases after two months of RAI and five weeks of AM administration. In this situation, RAI therapy was repeated. Three patients (17.6%) after six months, and another two (11.8%) after eight months, required an additional dose of 131I due to amiodarone-induced thyrotoxicosis (AIT). Twelve patients (70.6%) returned to spontaneous sinus rhythm within two months. Fourteen patients (82.4%) had sinus rhythm during follow-up after six and 12 months of treatment.

Conclusions: Preventive RAI in euthyroid (but previously hyperthyroid) patients with PAF before administration of AM may be the method of choice. This is particularly important for patients who will require permanent AM administration as a life-saving drug. (Endokrynol Pol 2014; 65 (4): 269–274)

Abstract

Introduction: Radioiodine (RAI) therapy is a standard procedure in the treatment of hyperthyroidism. However, the use of RAI in euthyroid patients requiring chronic administration of amiodarone (AM) where other antiarrhythmic drugs may lack efficacy is still controversial.

Objective: The aim of this study was to assess the safety and efficacy of an AM therapy prior to treatment with radioiodine therapy in euthyroid patients with permanent atrial fibrillation (PAF), who had been treated for hyperthyroidism in the past.

Material and methods: This was a retrospective observational study. Patients were assessed at baseline and two, six, eight, and 12 months after RAI therapy. 17 euthyroid patients with PAF were qualified to the RAI (female/male 3/14; age range 65 to 87, median 71). The patients required chronic administration of AM as a prophylaxis against sudden death.

Results: Each patient received an ablative dose of 800 MBq (22 mCi) of 131I. At baseline and during follow-up, no side effects of the therapy and no signs of drug intolerance were observed. Subclinical hyperthyroidism occurred in two (11.8%) cases after two months of RAI and five weeks of AM administration. In this situation, RAI therapy was repeated. Three patients (17.6%) after six months, and another two (11.8%) after eight months, required an additional dose of 131I due to amiodarone-induced thyrotoxicosis (AIT). Twelve patients (70.6%) returned to spontaneous sinus rhythm within two months. Fourteen patients (82.4%) had sinus rhythm during follow-up after six and 12 months of treatment.

Conclusions: Preventive RAI in euthyroid (but previously hyperthyroid) patients with PAF before administration of AM may be the method of choice. This is particularly important for patients who will require permanent AM administration as a life-saving drug. (Endokrynol Pol 2014; 65 (4): 269–274)

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Keywords

amiodarone-induced thyrotoxicosis; radioiodine therapy; permanent atrial fibrillation

About this article
Title

Results of preventive radioiodine therapy in euthyroid patients with history of hyperthyroidism prior to administration of amiodarone with permanent atrial fibrillation — a preliminary study

Journal

Endokrynologia Polska

Issue

Vol 65, No 4 (2014)

Pages

269-274

Published online

2014-08-29

DOI

10.5603/EP.2014.0036

Bibliographic record

Endokrynologia Polska 2014;65(4):269-274.

Keywords

amiodarone-induced thyrotoxicosis
radioiodine therapy
permanent atrial fibrillation

Authors

Agata Czarnywojtek
Małgorzata Zgorzalewicz-Stachowiak
Kosma Woliński
Maria Teresa Płazińska
Izabela Miechowicz
Barbara Kwiecińska
Rafał Czepczyński
Leszek Królicki
Marek Ruchała

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