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Hypothyroid/Afib/Low Potassium
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Hypothyroid/Afib/Low Potassium

Dear Dr.,
I was in the ER last week again for an episode of Afib that converted after 2 hours.  I am a 36 year old female and this was my third episode.  Last episode was almost 2 years ago, one week after childbirth.  My latest blood work showed low potassium and high TSH.  Could my low potassium and thyroid be the cause of the afib?  The potassium was just below the lowest reference value and I was not treated with any medication, only told to increase postassium in my diet.  I just found out yesterday about the high TSH and my cardiologist told me that  will have to see my PCP to deal with that issue.  I also have a tiny pfo that was diagnosed two years ago on echo.  Will I have to live with atrial arrythmias for the rest of my life? Could fixing the low potassium and thyroid problem help me?   Most of my arrhythmia is atrial, either afib or pac's, very seldom PVCs (according to my holter).  Can these turn into fatal arrhythmias?  Thank you for your time and answers to my questions.  
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SVTs and VT with a structurally normal heart are almost never fatal --  you will essentially have the same risk as anyone your age.

Atrial fibrillation is usually associated with low TSH, not high TSH.  Low potassium may play some role but many people have low potassium and rarely get atrial fib, so it is hard to imagine that it plays a huge role.  You are probably just a  susceptible person.  20 years from now we might be able to tell you exactly why but we can't right now.

The natural history of paroxysmal atrial fibrillation is that it starts as one episode every few years and progressively becomes more frequent.  When it is more frequent and if you are symptomatic despite rate control in atrial fibrillation, it might be worth trying an anti arrhythmic drug like flecainide or propafenone.  If you episodes are onces every few years, I would not start any medications now, especially if they are infrequent and self convert quickly.

I absolutely would not rush into any procedures with such infrequent atrial fib.  

I hope this helps.
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