Key result
Potassium imbalances affect ~78% of ED arrhythmia patients and link to SVT and VF.
Why the study?
Electrolyte disturbances are prevalent in emergency department patients and are a major cause of cardiac electrical instability, but limited data exist on their prevalence and ECG associations in tertiary-care hospitals in Peshawar.
Cross-Sectional (n=385)
No
Electrolyte imbalances, particularly potassium abnormalities, are highly prevalent in emergency department patients presenting with arrhythmias and correlate significantly with specific rhythms like supraventricular tachycardia, ventricular fibrillation, and complete heart block, emphasizing the need for immediate screening and correction.
Electrolyte screening merits attention in ED arrhythmia care; leaves open causality and outcome impact pending prospective trials.
Background: Electrolyte disturbances are prevalent in patients of the emergency department and are a major cause of cardiac electrical instability. Potassium, sodium, calcium, and magnesium disruptions may cause typical ECG abnormalities, and lead to life-threatening arrhythmia. But there is limited data on their prevalence and ECG associations in tertiary-care hospitals in Peshawar. Objective: To determine the frequency of major electrolyte abnormalities and evaluate their association with ECG-confirmed arrhythmias in adult emergency department patients Methods: The study was a descriptive cross-sectional study of 385 adult patients who presented ECG-confirmed arrhythmias. Serum electrolytes were used to measure levels within one hour of presentation and ECG findings were recorded. Chi-square and Fisher exact tests were used to analyze associations. Results: The most common electrolyte abnormalities were potassium (78.4%), sodium (32.7%), magnesium (31.9%), and calcium (15.8%). The most common arrhythmia was ventricular tachycardia (43.4%), atrial fibrillation (23.1), ventricular fibrillation (13), and supraventricular tachycardia (10.9). Widened QRS (48.6%), prolonged QT (34.5%), peaked T waves (33.2%), and prominent U waves (21.6%), were common ECG findings. There were significant correlations that existed between supraventricular tachycardia and potassium (p < 0.001), sodium (p = 0.001), and calcium (p < 0.001) abnormalities. There was a close relationship between potassium, calcium and magnesium abnormalities and VF (p = 0.001). Sodium (p < 0.001), magnesium (p = 0.002), and potassium (p = 0.016) disturbances were associated with complete heart block. There was no significant relationship with atrial fibrillation or ventricular tachycardia. ECGs have been associated with definite electrolyte abnormalities. Conclusion: Electrolyte imbalances are very common among emergency patients with arrhythmia and have a significant association with various tachyarrhythmia and conduction abnormalities. Timely detection and early correction with the use of ECG could help decrease the risk of serious cardiac events.
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Arif et al. (2026) conducted a cross-sectional in ECG-confirmed arrhythmias (n=385). Electrolyte abnormalities (potassium, sodium, calcium, magnesium) vs. Normal electrolyte levels was evaluated on Association between electrolyte abnormalities and ECG-confirmed arrhythmias. Electrolyte abnormalities were highly prevalent in emergency department patients with arrhythmias, most notably potassium imbalances (78.4%), which were significantly associated with supraventricular tachycardia (p<0.001) and ventricular fibrillation (p=0.001).
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