Scientists have found that potassium supplements may benefit AFib patients.
- A new study has shown that a lower threshold
for potassium supplementation after cardiac surgery saves patient costs
and does not create any further risks of atrial fibrillation or other
dysrhythmias.
- Atrial fibrillation is the most common clinical
arrhythmia worldwide, and nearly one-third of people who undergo cardiac
surgery experience it.
- Potassium, along with other electrolytes, plays
an important role in cardiac health.
It’s common practice for
patients to receive intravenous potassium supplementation after any form of
heart surgery if their potassium levels drop below 4.5 mEq/L (Milliequivalents
per liter). However, a new study, published in
Nearly
The risk of AFib
There are four chambers in
the heart — two atria and two ventricles — and atrial fibrillation occurs when
those chambers don’t function properly due to abnormal electrical activity,
which causes the atria and ventricles to contract at different speeds.
Advanced age, high blood pressure, hyperthyroidism, diabetes, binge drinking, and
a history of underlying heart disease are all factors that can contribute to
the development of atrial fibrillation. However, it is the most frequent
postoperative adverse event, and according to the authors of the new study, it
can lead to expensive hospital bills, longer hospital stays, and a higher risk
of death.
Researchers conducted a
randomized clinical trial at 23 cardiac surgical centers in the United Kingdom
and Germany between October 2020 and November 2023, utilizing 1,690 patients
with no history of atrial dysrhythmias who were scheduled for isolated coronary
artery bypass grafting surgery.
Of those, 843 were in the
group with the “relaxed” standard for supplementation. The lowered threshold
for potassium supplementation did not result in any further adverse
developments or increased heart dysrhythmias, and the cost savings per patient
in the “relaxed” group had a mean difference of $111.89.
What role
does potassium play in heart health?
Paul Drury,
MD, board certified cardiologist and associate medical director of
electrophysiology at MemorialCare Saddleback Medical Center in Laguna Hills,
CA, who was not involved in the study, told Medical News Today that potassium plays an
extremely important role as an electrolyte for cardiovascular health.
“Potassium travels in and
out of cardiac cells every time the heart beats. When potassium levels are very
low, people are at much higher risk of arrhythmias including life-threatening
ventricular fibrillation and even AFib. Severely elevated potassium levels are
also unsafe and can lead to very slow heart rates and a condition called heart
block. Severely elevated potassium levels can be fatal,” Drury said.
Maintaining a potassium
level between 3.6 mEq/L and 5.5 mEq/L is optimum for cardiovascular health in
general, he added.
“Allowing potassium levels
to get too low, which is normally due to medications, can increase the risk of
AFib or increase the burden of AFib. There is a risk of taking too much
potassium which can lead to serious heart conditions or even death.”— Paul
Drury, MD
Dr. Shephal Doshi, MD,
board certified cardiac electrophysiologist and director of cardiac
electrophysiology and pacing at Providence Saint John’s Health Center in Santa
Monica, CA, who also was not involved in the study, told Medical News
Today that the potassium-level range considered “normal” for most
people is quite broad.
“Potassium (along with
other electrolytes such as calcium and sodium and magnesium) are involved in
the electrical functions of cardiac cells and the ‘normal range’ between 3.5
and 4.5 mEq/L is the concentration in the blood plasma thought to generally
reflect a stable environment within the cardiac cells,” Doshi said.
“This is a somewhat broad
range and, on either extremes, can lead to electrical instability, especially
on the low end. This instability on the low end is thought to lower the
resistance of the cardiac atrial cell in developing fibrillation,” he added.
Who is at
the highest risk for atrial fibrillation?
Changes
in the electrical signals in the heart cause AFib. It can happen to anyone at
any age, but it is more common among older people.
Other
- Hypertension:
Long-term high blood pressure can place strain on the heart.
- Pulmonary embolism:
This is the medical term for a blood clot in
the artery that delivers blood to the lung.
- Heart disease: People
with underlying heart conditions have a higher risk of AFib. These
conditions include heart valve disease, heart failure, coronary artery disease,
and heart attack.
- Alcohol
consumption: Although regularly consuming large amounts of alcohol puts
people at the highest risk, even modest amounts can be a trigger for some
individuals. Other toxic drugs, such as methamphetamine, can also cause
AFib.
- Family
members with AFib: People with a
family history of AFib may be more likely to experience the condition themselves. - Sleep apnea: This can
increase a person’s risk of AFib, particularly when it is severe.
- Other
chronic conditions: Some long-term medical conditions — including thyroid problems, asthma, diabetes, and obesity — may
add to the risk.
Doshi added that anyone who
has already had AFib is at the highest risk.
“Other risk factors such as
a history of congestive heart failure and a weak heart muscle (cardiomyopathy)
have been shown to place people at higher risk. Generally speaking, the
cardiology field also tries to keep the electrolytes, especially potassium, in
the ‘high-normal’ range as low levels have been traditionally thought to
increase the risk of AFib,” he said.
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