Arrhythmias & electrophysiology
Association between amiodarone and thyrotoxicosis in patients with atrial fibrillation and hypothyroidism
Main finding · Thyrotoxicosis, hypothyroidism cohortResult — go to the resultAdjusted hazard ratio 5.18 95% CI 3.48–7.69Authors' conclusion
Although the magnitude of the effect of amiodarone on the risk of thyrotoxicosis is lower in patients with hypothyroidism, the risk remains elevated and mandates caution.
Study context
- Population
- Patients with a new diagnosis of atrial fibrillation (AF) between 2010 and 2023 in the Clalit Health Services database, Israelpatients with AF in the hypothyroidism cohort
- Participants
- 23,854 patients
- Exposure
- Exposure to amiodarone (time-dependent), amiodarone users vs non-users, in the hypothyroidism cohort and the normal thyroid cohort
- Amiodarone usersn = 8,212
- Non-usersn = 15,622reference
- Outcome
- Thyrotoxicosis, hypothyroidism cohort
- Follow-up
- During
Main finding
As reported in the abstract
Adjusted hazard ratio
5.18
95% CI 3.48–7.69
Events by group
Amiodarone usersvs non-users
adjusted hazard ratio 5.18 (95% CI 3.48–7.69)
- Thyrotoxicosis diagnosed during follow-up
- 107 patients
Observational data: associations, not effects.
Further findings
Incidence rate, per 1000 person-years
| Outcome | Amiodarone users | Non-users | Adjusted-hazard ratio (95% CI) | |
|---|---|---|---|---|
| Thyrotoxicosis, normal thyroid function cohort | 19.78 | 1.14 | 15.02 (13.56–16.64) | |
| 0.050.21520Adjusted-hazard ratio (log scale) |
Original publication
Association between amiodarone and thyrotoxicosis in patients with atrial fibrillation and hypothyroidism. Heart Rhythm. Published 5 August 2025. doi:10.
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