A Study of Auricular Fibrillation Following Operations for Goiter:

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Auricular fibrillation is the most common cardiac irregularity observed in the presence of hyperthyroidism, and in a considerable number of cases the arrhythmia first appears shortly after thyroidectomy has been performed. This investigation is based on 405 consecutive cases in which thyroidectomy was performed. Adenomatous goiter without clinical or laboratory evidence of hyperthyroidism was present in 192 cases, while in the remaining 213 cases hyperplastic or adenomatous goiter associated with hyperthyroidism was present. Auricular fibrillation was present before operation in 16 patients (7 per cent) who had hyperthyroidism. Postoperative auricular fibrillation developed in 31 (16 per cent) of the 197 patients who had normal rhythm before operation. The arrhythmia also was present before operation in two patients who had adenomatous goiter without hyperthyroidism.

The age of the patient, the type of goiter and the duration of hyperthyroidism appear to be the most important factors predisposing to the development of postoperative auricular fibrillation. The degree of elevation of the basal metabolic rate is of little significance. All the patients in this series were between the ages of thirty-five and sixty-one years, but only five were less than forty years of age. Nine patients had had symptoms of hyperthyroidism for more than thirty months; and in one instance a thyroidectomy had been performed for hyperthyroidism eight years before admission here, and there had been a gradual recurrence of symptoms after four years. Of 35 patients in whom enlargement of the thyroid was present, the symptoms had existed from one to more than. . .



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