Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy: the Atherosclerosis Risk in Communities (ARIC) Study

Abstract

<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Evaluating associations of circulating electrolytes with atrial fibrillation (AF) and burden of supraventricular arrhythmias can give insights into arrhythmia pathogenesis.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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<jats:sup>®</jats:sup> patch. Burden of other supraventricular arrhythmias [premature atrial contractions (PACs), supraventricular tachycardia] was determined with the Zio<jats:sup>®</jats:sup> patch. We used multivariable logistic and linear regression adjusting for potential confounders to determine associations of electrolytes with arrhythmia prevalence and burden.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Concentrations of circulating electrolytes present complex associations with selected supraventricular arrhythmias. Future studies should evaluate underlying mechanisms.</jats:p></jats:sec>