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Are Serum Potassium and Magnesium Levels Associated with Atrial Fibrillation After Cardiac Surgery?

Abstract：

OBJECTIVES:Potassium and magnesium are frequently administered after cardiac surgery to reduce the risk of atrial fibrillation (AF). The evidence for this practice is unclear. This study was designed to evaluate the relationship between serum potassium and magnesium levels and AF after cardiac surgery. DESIGN:Observational cohort study. SETTING:A cardiac intensive care unit in the United Kingdom. PARTICIPANTS:Patients undergoing cardiac surgery between January 2013 and November 2017. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Cardiac rhythm was assessed using continuous electrocardiogram (ECG) monitoring in 3,068 patients on the cardiac intensive care unit. Associations between serum potassium and magnesium concentrations extracted from hospital databases and postoperative AF were assessed using univariable and multivariable analyses. The association between electrolyte supplementation therapy and AF was also analyzed. AF developed within 72 hours of cardiac surgery in 545 (17.8%) of the 3,068 patients. After adjusting for logistic EuroSCORE, surgery type, cardiopulmonary bypass time and age, mean serum potassium concentration <4.5 mmol/L was associated with an increased risk of AF (odds ratio [OR] 1.43 (95% confidence interval (CI): 1.17-1.75), p < 0.001). Mean magnesium concentration <1.0 mmol/L was not associated with an increased risk of AF (OR 0.89, 0.71-1.13, p = 0.342), but the administration of magnesium was associated with increased risk of developing AF (OR 1.61, 1.33-1.96, p < 0.001). CONCLUSIONS:Maintaining a serum potassium concentration ≥4.5 mmol/L after cardiac surgery may reduce the incidence of postoperative AF. Magnesium supplementation was associated with an increased risk of postoperative AF. Prospective randomized trials are required to clarify these associations.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Howitt SH,Grant SW,Campbell NG,Malagon I,McCollum C

doi

10.1053/j.jvca.2019.10.045

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

1152-1159

issue

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(19)31120-6

journal_volume

pub_type

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Are Serum Potassium and Magnesium Levels Associated with Atrial Fibrillation After Cardiac Surgery?