Key result
Participants in the top quintile of circulating phosphorus had a lower prevalence of atrial fibrillation compared to the bottom quintile (OR 0.73; 95% CI 0.59-0.89).
Why the study?
Evaluating associations of circulating electrolytes with AF and burden of supraventricular arrhythmias can give insights into arrhythmia pathogenesis.
Are circulating electrolyte concentrations associated with the prevalence of atrial fibrillation and supraventricular ectopy in older adults?
Cross-Sectional (n=6,398)
Yes
Are circulating electrolyte concentrations associated with the prevalence of atrial fibrillation and supraventricular ectopy in older adults?
Higher circulating concentrations of phosphorus, magnesium, and potassium are associated with a lower prevalence of atrial fibrillation in older adults.
Higher phosphorus linked to lower AF prevalence in older adults; hypothesis-generating and requires prospective studies before any clinical inference.
Background Evaluating associations of circulating electrolytes with atrial fibrillation (AF) and burden of supraventricular arrhythmias can give insights into arrhythmia pathogenesis. Methods We conducted a cross-sectional analysis of 6,398 participants of the Atherosclerosis Risk in Communities (ARIC) study, ages 71-90, with data on serum electrolytes (magnesium, calcium, potassium, phosphorus, chloride, sodium). Prevalence of AF was determined from study 12-lead electrocardiograms and prior history of AF-related hospitalizations. A subset of 317 participants also underwent electrocardiographic recordings for up to 14 days using the Zio ® patch. Burden of other supraventricular arrhythmias [premature atrial contractions (PACs), supraventricular tachycardia] was determined with the Zio ® patch. We used multivariable logistic and linear regression adjusting for potential confounders to determine associations of electrolytes with arrhythmia prevalence and burden. Results Among 6,394 eligible participants, 614 (10%) had prevalent AF. Participants in the top quintiles of magnesium [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.62, 1.08], potassium (OR 0.82, 95%CI 0.68, 1.00), and phosphorus (OR 0.73, 95%CI 0.59, 0.89) had lower prevalence of AF compared to those in the bottom quintiles. No clear association was found for circulating chloride, calcium or sodium. Higher concentrations of circulating calcium were associated with lower prevalence of PACs using a standard 12-lead electrocardiogram, while higher concentrations of potassium, chloride and sodium were associated with higher PAC prevalence. Circulating electrolytes were not significantly associated with the burden of PACs or supraventricular tachycardia among a subset of 317 participants with extended electrocardiographic monitoring. Conclusion Concentrations of circulating electrolytes present complex associations with selected supraventricular arrhythmias. Future studies should evaluate underlying mechanisms.
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Alonso et al. (2019) conducted a cross-sectional in Atrial fibrillation and supraventricular ectopy (n=6,398). Circulating electrolytes vs. Bottom quintiles was evaluated on Prevalence of atrial fibrillation (OR 0.73, 95% CI 0.59-0.89). Participants in the top quintile of circulating phosphorus had a lower prevalence of atrial fibrillation compared to the bottom quintile (OR 0.73; 95% CI 0.59-0.89).
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