Electrolyte Abnormalities in Patients Presenting With Ventricular Arrhythmia (from the LYTE-VT Study)

Laslett, David B.; Cooper, Joshua M.; Greenberg, Richard M.; Yesenosky, George; Basil, Anuj; Gangireddy, Chethan; Whitman, Isaac R.

doi:10.1016/j.amjcard.2020.04.051

Cited by 20 publications

(15 citation statements)

References 14 publications

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“…These events cause the disturbance of local microcirculation and the disorder of cardiac electrophysiological activity, leading to the occurrence of VT/VF ( 14 – 16 ). The positive correlation between ventricular arrhythmias and diuretic use in patients with AMI is also described in the present study ( 17 ).…”

Section: Discussionsupporting

confidence: 87%

Impact of the caFFR-Guided Functional SYNTAX Score on Ventricular Tachycardia/Fibrillation Development in Patients With Acute Myocardial Infarction

Pan

Zhang

et al. 2022

Front. Cardiovasc. Med.

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AimsTo explore the relationship between the severity of coronary artery disease (CAD) and the occurrence of ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with acute myocardial infarction (AMI).MethodsWe retrospectively enrolled 705 patients with AMI, who were hospitalized and underwent percutaneous coronary intervention (PCI), in Nanfang Hospital from July 2017 to July 2020. Logistic regression analysis and backward stepwise approach were taken to select the correlation factors. The left and the receiver operating characteristic curves (ROC) analysis were plotted to observe the discriminative power of the SYNTAX score (SS)/caFFR-guided functional SS (FSScaFFR) on the incident VT/VF.ResultsAbout 58 (8.2%) patients experienced life-threatening VT/VF. The FSScaFFR (OR: 1.155; 95% CI: 1.047 to 1.273; p = 0.004) was an independent predictor of VT/VF after AMI. The ROC analysis showed that the discriminative power of FSScaFFR on the incident VT/VF was significantly better than SS (0.759 vs.0.695, p < 0.0001). Patients with VT/VF were categorized into 2 groups according to the interval between the onset of AMI and the VT/VF. The logistic regression analysis revealed that FSScaFFR was a significant independent correlation of early- and late-VT/VF.ConclusionThe incident VT/VF in patients with AMI is closely associated with the severity of CAD evaluated by SS and FSScaFFR. Compared to SS, FSScaFFR has a higher correlation with VT/VF, and FSScaFFR was demonstrated to be an independent correlation factor of incident VT/VF after AMI.

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Section: Discussionsupporting

confidence: 87%

Impact of the caFFR-Guided Functional SYNTAX Score on Ventricular Tachycardia/Fibrillation Development in Patients With Acute Myocardial Infarction

Pan

Zhang

et al. 2022

Front. Cardiovasc. Med.

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“…Gastrointestinal illness and recent changes to diuretic therapy were significantly correlated with the risk of VT/VF, probably because these are frequent causes of hypokalaemia (Laslett et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…A retrospective analysis of patients presenting with sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) showed that hypokalaemia was present in 35.7% of these patients, with 13.6% presenting with a serum [K + ] < 3.0 mM. Gastrointestinal illness and recent changes to diuretic therapy were significantly correlated with the risk of VT/VF, probably because these are frequent causes of hypokalaemia (Laslett et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

A carvedilol analogue, VK‐II‐86, prevents hypokalaemia‐induced ventricular arrhythmia through novel multi‐channel effects

Robinson

Alsalahat

Freeman

et al. 2022

British J Pharmacology

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Background and Purpose QT prolongation and intracellular Ca2+ loading with diastolic Ca2+ release via ryanodine receptors (RyR2) are the predominant mechanisms underlying hypokalaemia‐induced ventricular arrhythmia. We investigated the antiarrhythmic actions of two RyR2 inhibitors: dantrolene and VK‐II‐86, a carvedilol analogue lacking antagonist activity at β‐adrenoceptors, in hypokalaemia. Experimental Approach Surface ECG and ventricular action potentials (APs) were recorded from whole‐heart murine Langendorff preparations. Ventricular arrhythmia incidence was compared in hearts perfused with low [K+], and those pretreated with dantrolene or VK‐II‐86. Whole‐cell patch clamping was used in murine and canine ventricular cardiomyocytes to study effects of dantrolene and VK‐II‐86 on AP parameters in low [K+] and effects of VK‐II‐86 on the inward rectifier current (IK1), late sodium current (INa_L) and the L‐type Ca2+ current (ICa). Effects of VK‐II‐86 on IKr were investigated in transfected HEK‐293 cells. A fluorogenic probe quantified the effects of VK‐II‐86 on oxidative stress in hypokalaemia. Key Results Dantrolene reduced the incidence of ventricular arrhythmias induced by low [K+] in explanted murine hearts by 94%, whereas VK‐II‐86 prevented all arrhythmias. VK‐II‐86 prevented hypokalaemia‐induced AP prolongation and depolarization but did not alter AP parameters in normokalaemia. Hypokalaemia was associated with decreased IK1 and IKr, and increased INa‐L, and ICa. VK‐II‐86 prevented all hypokalaemia‐induced changes in ion channel activity and oxidative stress. Conclusions and Implications VK‐II‐86 prevents hypokalaemia‐induced arrhythmogenesis by normalizing calcium homeostasis and repolarization reserve. VK‐II‐86 may provide an effective treatment in hypokalaemia and other arrhythmias caused by delayed repolarization or Ca2+ overload.

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“…Electrolyte disturbances, especially hypomagnesemia and hypokalemia, are essential in setting the threshold low for cardiac arrhythmias [18]. In our patients, potassium and magnesium levels during the hospitalization did not differ significantly between the two groups and were around the normal level.…”

Section: Discussionmentioning

confidence: 41%

Cardiac Arrhythmias and COVID-19: Correlation With Disease Severity

Mahdi¹,

Bezawada²,

Özer³

et al. 2021

Cureus

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BackgroundCardiac arrhythmia is one of the life-threatening cardiovascular complications commonly reported in patients hospitalized with coronavirus disease 2019 . We aimed to evaluate the association between cardiac arrhythmias and disease severity based on oxygen requirement. MethodsIn this retrospective observational chart review-based study we recruited 396 patients hospitalized with COVID-19 from March 2020 to May 2020 from two regional medical centers in New Jersey, USA. Patients' baseline characteristics, secondary diagnoses, and laboratory findings were manually extracted and compared among two groups: patients with cardiac arrhythmias and those without. Poisson regression analysis was used to evaluate the correlation of cardiac arrhythmias and increased oxygen requirement, which are: room air (RA), nasal cannula (NC), high flow nasal cannula (HFNC), and bi-level positive airway pressure ventilation or invasive mechanical ventilation (BIPAP/MV). ResultsThe demographic characteristics of the patients were: aged 61 +/-18.7 years (mean +/-standard deviation); with 56% being male, and 44.9% of African American race. There were 16% patients on RA, 40% on NC, 15% on HFNC, and 29% on BIPAP/MV. The incidence of cardiac arrhythmias was 36.7% (20% pulseless electrical activity (PEA), 13.5% atrial fibrillation (AF). 56% of AF was new-onset arrhythmia. Compared to the RA group, the risk of cardiac arrhythmias was significantly higher in BIPAP/MV (OR 3.3; 95% CI 1.8 -6.2, p <0.001) and HFNC (OR 2.9; 95% CI 1.5-5.7, p0.001), but not in NC group (OR 0.95; 95% CI 0.4-1.8, p0.89).Compared to patients without arrhythmias, patients with arrhythmias were older (mean age 71 vs. 56 years, p <0.001) and had more comorbidities (Charlson comorbidity index (CCI), 4.7 vs. 2.9, p <0.001). The continued therapy of angiotensin-converting enzyme inhibitors or angiotensin-II receptor blockers did not seem to be associated with increased or decreased risk of cardiac arrhythmias. ConclusionThe incidence of cardiac arrhythmias among hospitalized COVID-19 patients was 36.7% with PEA being common in patients who succumbed to death, and AF in those patients who survived. The incidence of cardiac arrhythmias positively correlated with disease severity based on oxygen requirement and was higher among patients requiring HFNC or BIPAP/MV.

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Electrolyte Abnormalities in Patients Presenting With Ventricular Arrhythmia (from the LYTE-VT Study)

Cited by 20 publications

References 14 publications

Impact of the caFFR-Guided Functional SYNTAX Score on Ventricular Tachycardia/Fibrillation Development in Patients With Acute Myocardial Infarction

Impact of the caFFR-Guided Functional SYNTAX Score on Ventricular Tachycardia/Fibrillation Development in Patients With Acute Myocardial Infarction

A carvedilol analogue, VK‐II‐86, prevents hypokalaemia‐induced ventricular arrhythmia through novel multi‐channel effects

Cardiac Arrhythmias and COVID-19: Correlation With Disease Severity

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