Table 2.

Research Opportunities in Thyroid Hormones and Cardiac Electrophysiology

• Studies of thyroid hormone effects on transcriptional and proteomic profiles, and on microRNA and long non-coding RNA expression in atrial, ventricular, nodal, and His-Purkinje myocytes;

• Analyses of thyroid hormone sensitive gene regulatory networks to examine gene expression/phenotype relationships;

• Generation of new experimental animal models to explore the role of altered thyroid hormone signaling as a modulator of arrhythmia risk;

• Mechanisms of amiodarone effects on ion channel transcription;

• Studies in animal models and humans to identify novel biomarkers of the electrophysiological effects of thyroid hormone;

• Identification of the optimal target populations, based on thyroid function test thresholds and absolute risk of arrhythmias, for randomized clinical trials to test the clinical impact of altering thyroid function, particularly of the optimal management of subclinical hyperthyroidism and subclinical hypothyroidism;

• Studies of the effects of levothyroxine and thyroid hormone therapies that include T3 on the conduction system and the role of β-adrenergic blocking drugs in mitigating risk;

• Use of large databases to examine current practices in the co-existent management of arrhythmias and thyroid disease;

• Management pathways of surveillance for and management of amiodarone-induced thyroid toxicity; common pathways underlying toxicity to the lung.