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Transient atrial fibrillation in hypertensive patients with thiazide induced hypokalaemia
1Department of Medicine, Mubarak Hospital, Kuwait.
Insights
Thiazide diuretics can cause hypokalemia, leading to atrial fibrillation (AF) in hypertensive patients. Potassium replacement restored normal heart rhythm, suggesting a link between thiazide-induced low potassium and AF.
Area of Science:
- Cardiology
- Pharmacology
- Nephrology
Background:
- Thiazide diuretics are commonly prescribed for hypertension.
- Hypokalemia is a known side effect of thiazide therapy.
- Atrial fibrillation (AF) is a common cardiac arrhythmia.
Observation:
- Three hypertensive patients on long-term thiazide therapy presented with new-onset atrial fibrillation (AF).
- All patients exhibited hypokalemia (low potassium levels).
- No underlying cardiac or pericardial disease was identified.
Findings:
- Intravenous and oral potassium chloride administration successfully restored sinus rhythm in all patients.
- The study suggests a causal relationship between thiazide-induced hypokalemia and the development of AF.
- Exclusion of other common causes strengthens the association.
Implications:
- Clinicians should monitor potassium levels in hypertensive patients on thiazide diuretics.
- Hypokalemia should be considered as a potential cause of new-onset AF.
- Prompt potassium replacement may resolve AF in susceptible patients.
Abstract:
During the previous 34 months, 3 hypertensive patients on long-term thiazide therapy were admitted to the medical department, Mubarak Hospital, Kuwait, with atrial fibrillation (AF) and hypokalaemia. They received potassium chloride by intravenous infusion, followed by oral therapy with reversion to sinus rhythm. There were no clinical, electrocardiographic, radiological, or echocardiographic signs of cardiac or pericardial disease, and the other usual cases of AF were also excluded. The contribution of thiazide-induced hypokalaemia to the occurrence of AF in our patients is discussed.