This protocol covers thyroid storm presenting with tachycardia at or above 130 beats per minute — including cases in which the elevated heart rate occurs in the context of atrial fibrillation. The presence of atrial fibrillation is a key comorbidity that directly shapes the management approach.
The primary objective is heart rate reduction. Management is built around a beta1-selective adrenergic antagonist strategy for rate control. When atrial fibrillation is present alongside tachycardia, additional therapeutic considerations — including rhythm management and anticoagulation — are incorporated. The full agent selection, clinical decision points, and sequencing are detailed in the complete protocol.