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To the Editor Over and above the substantial risk of developing a suppressed thyrotropin level following replacement therapy,1 there is a risk that thyroid replacement therapy may precipitate transition to persistent atrial fibrillation (AF), with all its attendant sequelae, when replacement therapy is administered to patients with unrecognized paroxysmal AF (PAF).
Jolobe OMP. Treatment of Borderline Elevated Thyrotropin Levels. JAMA Intern Med. 2015;175(3):466. doi:10.1001/jamainternmed.2014.7847