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Association between the preprocedural serum potassium level and atrial fibrillation recurrence after catheter
Zejun Yang1, Jue Wang1, Chao Jiang1
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
Insights
Lower serum potassium levels increase the risk of atrial fibrillation (AF) recurrence after catheter ablation. An optimal potassium range of 4.41-4.60 mmol/L was identified for better outcomes.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Research
Background:
- The link between serum potassium and atrial fibrillation (AF) recurrence post-catheter ablation is not well-established.
- Understanding this association is crucial for improving ablation success rates.
Purpose of the Study:
- To examine the influence of preprocedural serum potassium levels on the likelihood of AF recurrence in patients undergoing catheter ablation.
- To identify an optimal serum potassium range for patients undergoing AF ablation.
Main Methods:
- Analysis of data from the prospective Chinese Atrial Fibrillation Registry Study.
- Inclusion of 4838 patients who underwent de novo catheter ablation, excluding those with prior ablation or missing baseline potassium.
- Utilized restricted cubic spline and Cox proportional models to assess 1-year AF recurrence risk across different serum potassium levels.
Main Results:
- A U-shaped relationship was observed between preprocedural serum potassium and 1-year AF recurrence (P nonlinear = .048).
- Significantly higher AF recurrence risk was noted in patients with the lowest serum potassium (≤4.00 mmol/L) compared to the optimal range (4.41-4.60 mmol/L) (HR 1.26; P = .010).
- Other potassium levels showed non-significant trends toward increased recurrence risk.
Conclusions:
- The association between preprocedural potassium and AF recurrence is U-shaped, highlighting an optimal range of 4.41-4.60 mmol/L.
- Lower serum potassium levels are linked to an elevated risk of AF recurrence following catheter ablation.
Background:
The association between serum potassium and atrial fibrillation (AF) recurrence after catheter ablation remains unclear.
Objective:
The purpose of this study was to investigate whether preprocedural serum potassium level influences AF recurrence in patients who underwent catheter ablation.
Methods:
We used data of patients with AF who underwent de novo catheter ablation from the prospective Chinese Atrial Fibrillation Registry Study. Patients with prior ablation and without baseline serum potassium were excluded. The primary outcome was 1-year AF recurrence after a 3-month blanking period from the ablation procedure. Restricted cubic spline and Cox proportional models were used to compare outcomes across serum potassium groups.
Results:
A total of 4838 patients with AF who underwent de novo catheter ablation was enrolled. At 1 year, AF recurrence occurred in 1347 patients (27.8%). The relationship between preprocedural serum potassium levels and 1-year AF recurrence after ablation presented as U shape (P for nonlinear = .048). Compared with the group of serum potassium within 4.41-4.60 mmol/L, the risk of AF recurrence increased significantly in the lowest serum potassium group (≤4.00 mmol/L) after multivariable analysis (hazard ratio [HR] 1.26; 95% confidence interval 1.06-1.51; P = .010). Other groups with lower or higher serum potassium levels including 4.01-4.20 mmol/L (HR 1.18), 4.21-4.40 mmol/L (HR 1.16), 4.61-4.80 mmol/L (HR 1.07), and ≥4.81 mmol/L (HR 1.11) showed nonsignificant higher recurrence risk.
Conclusion:
The relationship between preprocedural potassium and AF recurrence was U shaped, with an optimal potassium range (4.41-4.60 mmol/L). Lower potassium level is associated with increased AF recurrence risk after catheter ablation.
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