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Thyrotoxic periodic paralysis (TPP) is a rare and potentially life-threatening disorder characterized by transient muscle weakness due to hypokalemia in the setting of hyperthyroidism. We present a case of a 32-year-old male with no prior history of thyroid disease who developed acute, progressive paralysis of all 4 extremities. Laboratory findings revealed profound hypokalemia, hypophosphatemia, and elevated lactate. Electrocardiography showed new-onset atrial fibrillation with a rapid ventricular response. Thyroid function tests confirmed hyperthyroidism, and further evaluation led to the diagnosis of Graves disease. The patient was treated with intravenous potassium and phosphorus replacement, leading to full neurological recovery within 24 hours. He was subsequently started on carbimazole for long-term thyroid hormone suppression. The occurrence of atrial fibrillation in TPP is an uncommon yet significant complication. Additionally, elevated lactate is an extremely rare finding.
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http://dx.doi.org/10.1210/jcemcr/luaf193 | DOI Listing |
Cardiol Rev
September 2025
Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Patients with atrial fibrillation, venous thrombosis, and mechanical heart valve (MHV) regularly undergo procedures on a daily basis, for which they require bridging anticoagulation, but this poses significant challenges. Bridging anticoagulation involves temporary interruption of long-term anticoagulation therapy for procedures and continued overlap with short-acting anticoagulants during perioperative period. Heparin-based agents are often used for overlapping in perioperative period to reduce the risk of thromboembolism, but the evidence for benefit particularly in patients with MHV remains limited.
View Article and Find Full Text PDFInterdiscip Cardiovasc Thorac Surg
September 2025
Department of Electrophysiology, Abbott Inc, Chicago, IL.
We report the first use of the EnSite X system for intraoperative electrophysiological mapping during a robotic hybrid ablation (ROK-AF procedure) for long-standing persistent atrial fibrillation. Epicardial ablation targets were identified, and post-ablation electrical silencing was validated. Unlike conventional systems, its orientation-independent omnipolar technology provides directional activation vectors, high-resolution electrograms, and peak frequency analysis, thereby enhancing substrate characterisation.
View Article and Find Full Text PDFJ Interv Card Electrophysiol
September 2025
Cardiac Ablation Solutions, Medtronic, Minneapolis, MN, USA.
Background: Catheter ablation is beneficial in patients with symptomatic persistent atrial fibrillation (PerAF), and pulsed field ablation (PFA) is a promising energy source to safely and durably create ablation lesions. However, catheter-specific "PFA waveforms and designs" result in effectiveness and safety profiles that are not transferable to other PFA technologies. A head-to-head comparison between the dual-energy, wide-footprint lattice-tip (Sphere-9, Medtronic) and pentaspline PFA catheter (Farawave, Boston Scientific) is not yet available.
View Article and Find Full Text PDFAnn Emerg Med
September 2025
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Rev Med Suisse
August 2025
Service de cardiologie, HFR Fribourg - Hôpital cantonal, 1752 Villars-sur-Glâne.
Atrial fibrillation (AF) is common in the elderly and often incidental. While anticoagulation is facilitated by risk-stratification scores, rate versus rhythm-control in the elderly and likely asymptomatic population remain challenging. We report an 80-year-old male with newly diagnosed slow AF, referred for an electrical cardioversion after amiodarone loading.
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