Introduction: Amiodarone is a highly effective antiarrhythmic used in the management of several tachyarrhythmias. It associated with many undesirable side effects including thyroid dysfunction: amiodarone-induced hypothyroidism (AIH) occurs in approximately 22% of patients on long-term amiodarone and amiodarone-induced thyrotoxicosis (AIT) in 3%. AIT may be dramatic in its presentation and challenging to manage: many patients have refractory arrhythmias which require its continuation and cessation does not necessarily resolve AIT. Surgical treatment with total thyroidectomy may therefore be required. The cardiac comorbidities in this patient group present a challenge in perioperative management.
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