Does hyperthyroidism occur due to an increased dose of Amiodorane in a 54-year-old with A-fib?

Hello doctor,

I am a 54-year-old man. Three years after looking after a senior parent 24/7, I developed A-fib. I was on Amiodarone and Bisoprolol before I had a cardioconversion. I remained A-fib-free for three years while on 100 mg of Amiodarone. In the fall of last year, my parents' health significantly declined, and my A-fib returned. Due to a lack of access to a physical doctor, I used 400 mg of Amiodarone for a month and developed hyperthyroidism. I got good news about 11 days ago that the T4 hormone had dropped from 36 to 24 micrograms per deciliter. The T3 value was still double the limit, but no background laboratory tests were done before. Even though my A-fib events over the last two months have been sporadic one hour every other day or so. But in the last week, I woke up early morning hours with A-fib. It has been four nights in a row. I woke up with sweats, and my sleep was broken, losing two hours in the morning with A-fib lasting for five hours. Two months ago, the cardiologist prescribed 50 mg of Flecanaide BID and 5 mg of Bisoprolol BID three weeks ago, and I increased the Flecanaide to 150 mg daily. Four days ago, I bumped it up to 100 mg BID. Today I saw the cardiologist, and they would not grant me a physical appointment until three months later. I was lectured it was dangerous to have bumped my Flecanaide like that, citing death. I do not how valid that is, as the dosage seems within range in what I have researched. I simply cannot get an appointment. Four months ago, while I was still on Amiodarone my A-fib spiked. I bumped it up from 100 mg daily to 400 mg. I had been on 100 mg Amiodarone for three years and A-fib free. Life's stress precipitated its return with minimum medications. Three years ago, when my A-fib was constant and I had a high pulse rate, I was on 400 mg Amiodarone too, till a cardioconversion eliminated the A-fib with continued low-dose Amiodarone. I also got lectured today that I have screwed up my thyroid by being reckless with the increased dose of Amiodarone. I do not know from a cardiac or endocrine perspective if it was reckless of me to bump up the Amiodarone from 100 to 400 mg. I was only on 400 mg for one month. It was anticipated it would affect my thyroid, will it?

Today, Flecanaide was reduced back to 50 mg BID, and Bisoprol was eliminated. I now have to take Atenolol at 50 mg BID. He cited it to be more strong than Bisoprolol. I now have to take Xarelto too, in prepping me for another cardioconversion. I am still hoping once the thyroid calms down, the A-fib will settle more. My ejection fraction was 57 two months ago and will be getting another one next week. What are your thoughts on the situation?

Hello doctor,

Thank you. My cardiologist is very strict about adhering to medications. I have no other choice than to follow his direction 100 percent. My other questions are, I bumped up the Amiodarone from 100 mg to 400 mg as I was on the 100 mg for over two years. Was that the wise move to make, or should something else have been used at that point? The odds would be that I would not develop hyperthyroidism. I am now back at the 50 mg BID and will see how the Atenolol will respond. He infers it to be strong and now wants to do another cardioconversion and ablation. What are your thoughts on the efficacy of either and the risks for ablation? Are risks with ablation hinged on the doctors' manual dexterity that day or just poor luck that day? Damaged heart valves are not a risk I wish for in a taxed healthcare system. I am 54 years old and was A-fib-free for three years on minimum Amiodarone. I am genetically predisposed, but my mother's care precipitated it. She got to 96 age with congestive heart failure with A-fib as well. I have been warned a man my age should not have an A-fib. I took care of her for eight years, and it was stressful. I estimate I am 10 to 20 percent in A-fib with a pulse of 100 beats per minute. In 2019, I was in A-fib with a pulse of 120 beats per minute more than 60 percent of the time. Back then, I was obliged to do cardioversion. What is considered a serious situation, a cardioconversion or ablation?

Hi doctor,

Thanks for the reply. What should I do after my cardioversion?