Occurrence of hypokalemia in patients with new-onset atrial fibrillation presenting within 48 hours

Background: Atrial fibrillation (AF) is the most common cardiac rhythm disorder. Various reversible conditions, particularly electrolyte abnormalities, may contribute to its development or persistence. Reduced serum potassium levels can influence cardiac electrical activity and myocardial repolarization, potentially increasing the propensity for atrial arrhythmias. This study was therefore undertaken to assess the frequency of hypokalemia among patients presenting with new-onset AF within 48 hours of symptom onset. This study was therefore undertaken to determine the frequency of hypokalemia among patients presenting with new-onset AF within 48 hours of symptom onset. Methods: The study design was descriptive cross-sectional study at Fauji foundation hospital Peshawar. A total of 102 patients with new-onset atrial fibrillation, diagnosed on clinical and electrocardiographic assessment, were enrolled. The required sample size was calculated using the WHO Sample Size Calculator based on an anticipated hypokalemia proportion of 4.43%, a 4% margin of error, and a 5% level of significance. All participants underwent clinical assessment and serum electrolyte measurement. Hypokalemia was defined as a serum potassium concentration below 3.5 mmol/L. Results: The mean age of the study population was 39.9 ± 16.22 years. The mean duration of presenting symptoms was 1.39 ± 0.49 hours, while the mean systolic blood pressure and body mass index were 139.9 ± 13.98 mmHg and 28.71 ± 6.82 kg/m², respectively. Among the 102 patients with new-onset atrial fibrillation, hypokalemia was identified in 7 patients (6.9%). Hypokalemia was significantly associated with higher body mass index (p=0.017), hypertension (p=0.013), and diabetes mellitus (p=0.011). Conclusion: Hypokalemia identified in a proportion of patients presenting with new-onset atrial fibrillation was significantly associated with diabetes mellitus, hypertension, and increased body mass index. Assessment of routine potassium may be particularly important in these patients.