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Relationship between serum potassium concentration and risk of recurrent ventricular tachycardia or ventricular

G F Michaud1, C Sticherling, H Tada

  • 1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0022, USA.

Journal of Cardiovascular Electrophysiology
|November 9, 2001
PubMed

Insights

Electrolyte abnormalities, like low potassium, do not significantly increase the risk of recurrent ventricular arrhythmias in patients with structural heart disease. Implantable defibrillators may still be reasonable for these patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Electrolyte abnormalities are cited as a correctable cause of life-threatening ventricular arrhythmias.
  • Current guidelines recommend defibrillator implantation for ventricular tachycardia or fibrillation with electrolyte abnormalities, but supporting data are limited.

Purpose of the Study:

  • To investigate the risk of recurrent sustained ventricular arrhythmia in patients with low serum potassium at the time of an initial event.

Main Methods:

  • A cohort of 169 patients with sustained ventricular arrhythmia and available serum potassium levels underwent defibrillator implantation.
  • Patients had structural heart disease and a mean ejection fraction of 0.32 ± 0.15.
  • Serum potassium levels were categorized as <3.5 mEq/L, 3.5–5.0 mEq/L, or >5.0 mEq/L.

Main Results:

  • 30% of patients had abnormal serum potassium (<3.5 or >5.0 mEq/L) at the time of the initial arrhythmia.
  • Five-year freedom from recurrent sustained ventricular arrhythmia was 18% for the entire cohort.
  • No significant difference in recurrence-free survival was observed across different potassium level groups (P = 0.1).

Conclusions:

  • Abnormal serum potassium at the time of initial ventricular arrhythmia in patients with structural heart disease may indicate high risk for recurrence.
  • Implantable defibrillator therapy may be a reasonable consideration for these patients.
Abstract

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