Electrolyte Abnormalities in Patients Presenting With Ventricular Arrhythmia (from the LYTE-VT Study)

Autor: Isaac R. Whitman, David B. Laslett, Richard M. Greenberg, Joshua M. Cooper, Chethan Gangireddy, George A. Yesenosky, Anuj Basil
Rok vydání: 2020
Předmět:
Diarrhea
Male
medicine.medical_specialty
Heart disease
Vomiting
medicine.medical_treatment
Sodium Chloride Symporter Inhibitors
Myocardial Ischemia
Water-Electrolyte Imbalance
Hypokalemia
Electrolyte
030204 cardiovascular system & hematology
Spironolactone
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
Sodium Potassium Chloride Symporter Inhibitors
Internal medicine
Medicine
Humans
In patient
Magnesium
cardiovascular diseases
030212 general & internal medicine
Renal Insufficiency
Chronic
Diuretics
Aged
Heart Failure
business.industry
Electronic medical record
Nausea
Stroke Volume
Middle Aged
medicine.disease
Heart failure
Case-Control Studies
Ventricular fibrillation
Ventricular Fibrillation
cardiovascular system
Cardiology
Tachycardia
Ventricular
Female
Diuretic
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Cardiomyopathies
Zdroj: The American journal of cardiology. 129
ISSN: 1879-1913
Popis: Electrolyte abnormalities are a known trigger for ventricular arrhythmia, and patients with heart disease on diuretic therapy may be at higher risk for electrolyte depletion. Our aim was to determine the prevalence of electrolyte depletion in patients presenting to the hospital with sustained ventricular tachycardia or ventricular fibrillation (VT/VF) versus heart failure, and identify risk factors for electrolyte depletion. Consecutive admissions to a tertiary care hospital for VT/VF were identified between July 2016 and October 2018 using the electronic medical record and compared with an equal number of consecutive admissions for heart failure (CHF). The study included 280 patients (140 patients in each group; mean age 63, 60% male, 59% African American). Average EF in the VT/VF and CHF groups was 30% and 33%, respectively. Hypokalemia (K3.5 mmol/L) and severe hypokalemia (K3.0 mmol/L) were present in 35.7% and 13.6%, respectively, of patients with VT/VF, compared to 12.9% and 2.7% of patients with CHF (p0.001 and p = 0.001, respectively, between groups). Hypomagnesemia was found in 7.8% and 5.8% of VT/VF and CHF patients, respectively (p = 0.46). Gastrointestinal illness and recent increases in diuretic dose were strongly associated with severe hypokalemia in VT/VF patients (odds ratio: 11.1 and 21.9, respectively; p0.001). In conclusion, hypokalemia is extremely common in patients presenting with VT/VF, much more so than in patients with CHF alone. Preceding gastrointestinal illness and increase in diuretic dose were strongly associated with severe hypokalemia in the VT/VF population, revealing a potential opportunity for early intervention and arrhythmia risk reduction.
Databáze: OpenAIRE
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