Pivotal roles of risk factors for incident atrial fibrillation in patients with newly diagnosed hyperthyroidism

We have read with great enthusiasm the recently published article entitled “Association of inflammation with atrial fibrillation (AF) in hyperthyroidism” by Ozaydin and coworkers. In that very well-designed study, Ozaydin and coworkers tried to evaluate the relationship between serum levels of high-sensitivity C-reactive protein (HsCRP), as a marker of inflammation and the development of AF in patients with hyperthyroidism. They concluded that HsCRP, an indicator of inflammation, free T4 and left atrial (LA) diameter are associated with the development AF in patients with hyperthyroidism. AF is the most commonly encountered cardiac arrhythmia, and is expected to affecting millions of people world-wide. AF is a complex condition with several possible contributing factors. It is an arrhythmia with a very clearly observed predisposition for the aged patients. Hyperthyroidism is a relative uncommon but important cause of AF. AF occurs in up to 15% of patients with hyperthyroidism compared to 4% of people in the general population and is more common in men and in patients with hyperthyroidism. Several potential mechanisms could be considered for the effect of thyroid hormones on AF risk, including elevation of LA pressure secondary to increased left ventricular mass and impaired ventricular relaxation, ischemia resulting from increased resting heart rate, and increased atrial eopic activity. AF is responsible for considerable morbidity and mor-