Arrhythmias & electrophysiology
Thyrotropin Directly Affects Cardiac Electrophysiology and Is Associated With Atrial Fibrillation (AF) Prevalence
Authors' conclusion
Individuals with SH exhibit an increased prevalence of AF, which is likely in part due to a direct effect of TSH on ion channel expression in cardiomyocytes via the TSHR/cAMP/PKA pathway.
Study context
- Population
- Patients diagnosed with subclinical hypothyroidism (SH) 2007–2020 with an ECG within 7 days of diagnosis; HL-1 and neonatal rat cardiomyocytes
- Participants
- 2,311 patients
- Exposure
- Thyroid-stimulating hormone (TSH) 4-10 mU/L vs >10 mU/L
- Outcome
- AF prevalence by TSH level
Main finding
As reported in the abstract
AF documented
P < 0.0001
Observational data: associations, not effects.
Further findings
Independent factors associated with AF (multivariable regression)
- Elevated TSH an independent risk factor for AF
Mechanistic effects of TSH in cardiomyocytes
- TSHR confirmed in cardiomyocytes
- TSH changed ion channel expression, promoting action potential prolongation
- TSH increased beating rate in neonatal rat cardiomyocytes
- TSHR/cAMP/PKA/CREB cascade identified as potential regulator of electrical remodeling
Original publication
Thyrotropin Directly Affects Cardiac Electrophysiology and Is Associated With AF Prevalence. Circ Arrhythm Electrophysiol. Published 3 December 2025. doi:10.
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