Arrhythmias & electrophysiologySecondary analysis
Hypokalaemia and atrial fibrillation detected by implanted loop recorders
- Secondary analysis of the LOOP randomised trial
- post hoc analysis
- exploratory
Authors' conclusion
This exploratory study found that low p-potassium was associated with day-to-day AF occurrence, particularly for longer episodes and when deviating from the individual's usual level.
Study context
- Population
- Individuals with stroke risk factors undergoing implantable loop recorder (ILR) screening for AF (continuous ECG monitoring)ILR + blood test data available
- Participants
- 1,334 individuals
- Comparison
- Lower vs higher plasma potassium in relation to daily AF
- Primary endpoint
- Daily AF >60 min in relation to p-potassium
Primary result
As reported in the abstract
Daily AF >60 min vs p-potassium
Mean difference in p-potassium, days with AF vs without (mmol/L)
−.21 (−.25; −.18)
IRR of AF, hypokalaemia (<3.5 mmol/L) vs normal range (self-controlled case analysis)
2.24 (1.29-3.88)
aOR of AF per mmol/L p-potassium (five-fold increase in odds per mmol/L decrease)
.20 (.15-.28)
Further findings
Hypokalaemia by AF episode duration
- Hypokalaemia on days with AF <60 min
- 5.1%
- Hypokalaemia on days with AF >240 min
- 19.1%
AF odds per mmol/L p-potassium, effect modification
- aOR when p-potassium deviated from individual's usual value
- .15 (.10-.24)
- aOR in participants receiving diuretics
- .28 (.17-.47)
- deviation P-interaction = .001
- diuretics P-interaction < .0001
Original publication
Hypokalaemia and atrial fibrillation detected by implanted loop recorders. Eur Heart J. Published 30 August 2025. doi:10.1093/eurheartj/ehaf623
Summarised from the published abstract; every number is checked against it