The relationship between serum potassium levels and cardiac arrhythmias in left ventricular assist device (LVAD) recipients: a comprehensive analysis and prognostic evaluation
- 27.08.2024
- Original Paper
Erschienen in:
- Verfasst von
- Gianmarco Lombardi
- Alessia Gambaro
- Pietro Manuel Ferraro
- Elisa De Tomi
- Flavio L. Ribichini
- Giovanni Gambaro
- Erschienen in
- Clinical Research in Cardiology | Ausgabe 10/2025
Abstract
Background
This study aimed to comprehensively analyze the relationship between serum potassium (K+) levels and the risk of de novo cardiac arrhythmias in left ventricular assist device (LVAD) recipients.
Methods
We performed a retrospective study using the INTERMACS registry. Data was collected on adult patients with available K+ measurements taken 1-month post-LVAD implantation. K+ levels were the main exposure of interest and were analyzed as a continuous and categorical variable (quartiles of baseline K+ distribution). The main outcome of interest was the occurrence of de novo arrhythmia events, either sustained (ventricular [VA] or supraventricular arrhythmia [SVA]) or not sustained (atrial fibrillation/flutter [AF]). All-cause mortality was evaluated as the secondary outcome. Multivariable adjusted time-dependent Cox regression models and natural splines were used to describe the relationship between the exposure and outcomes of interest.
Results
10,570 patients met our inclusion criteria. A significant and consistent relationship was observed between the lowest quartile of longitudinal K+ and the risk of arrhythmic events (HR 1.28, 95% CI 1.08, 1.53, p = 0.005) as well as in the highest K+ quartile (HR 1.24, 95% CI 1.02, 1.49, p = 0.027).
A similar relationship was confirmed in the stratified analysis of arrhythmia types for SVAs and AF. The data were reflected in a U shaped relationship. Similarly, the highest and lowest quartiles of longitudinal K+ were independently associated with a significant increase in the HR of death, which was reflected by a U shaped relationship.
Conclusions
Our study reveals a significant U shaped relationship between low and high K + levels and cardiac arrhythmias in LVAD patients, particularly SVAs and AF. Both high and low K + levels negatively impacted patient survival.
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- Titel
- The relationship between serum potassium levels and cardiac arrhythmias in left ventricular assist device (LVAD) recipients: a comprehensive analysis and prognostic evaluation
- Verfasst von
-
Gianmarco Lombardi
Alessia Gambaro
Pietro Manuel Ferraro
Elisa De Tomi
Flavio L. Ribichini
Giovanni Gambaro
- Publikationsdatum
- 27.08.2024
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Clinical Research in Cardiology / Ausgabe 10/2025
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692 - DOI
- https://doi.org/10.1007/s00392-024-02531-1
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