The Use of Quinidine for Auricular Fibrillation in Hyperthyroidism

Abstract

Auricular fibrillation occurs, either in its continuous form or in paroxysms of long or short duration, in about 10 per cent of all patients with hyperthyroidism. The preoperative treatment of these patients consists of the usual measures plus the administration of digitalis in sufficient amounts to reduce the heart rate to approximately 90 beats per minute. During the period of preparation for operation, no attempt is made to re-establish the normal heart rhythm. In approximately one-half of all patients with hyperthyroidism and auricular fibrillation, the heart rhythm spontaneously becomes regular during the first week or ten days after subtotal thyroidectomy, and normal rhythm can be restored in nearly one-half of the remaining patients by the use of quinidine sulfate.

Case Report

The following case report illustrates the successful use of quinidine sulfate in the treatment of auricular fibrillation which persisted after thyroidectomy.

The patient, a white man fifty-four years of age, was admitted to the hospital on October 23, 1939 because of nervousness, palpitation, and loss of weight. The loss of weight had begun about six months earlier and had amounted in all to about thirty pounds. About three months previous to admission he began to get extremely nervous. Along with this, there was loss of strength, trembling of the hands, and profuse perspiration. The basal metabolic rate was plus 19 per cent in July, 1939. A diagnosis of hyperthyroidism was made at that time. The patient was placed on a two weeks' course of Lugol's solution, followed by Iodosin. . .