Arrhythmias & electrophysiologyRandomised controlled trial
Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias
- Randomised controlled trial
- multicentre
- open-label
- event-driven
- superiority
Authors' conclusion
Among participants with any cardiovascular disease who had an ICD and were at high risk for ventricular arrhythmias, a treatment-induced increase in plasma potassium levels led to a significantly lower risk of appropriate ICD therapy, unplanned hospitalization for arrhythmia or heart failure, or death from any cause than standard care.
Study context
- Population
- Patients with an ICD (high risk for ventricular arrhythmias) and baseline plasma potassium ≤4.3 mmol per liter, Denmark
- Participants
- 1,200 patients
- Comparison
- Treatment to increase plasma potassium to high-normal vs standard care
- High-normal potassiumn = 600
- Standard caren = 600reference
- Primary endpoint
- Composite of:
- Documented sustained VT or appropriate ICD therapy
- Unplanned hospitalization (>24 hours) for arrhythmia or HF
- Death from any cause (time-to-first-event)
- Follow-up
- Median 39.6 months
Primary result
As reported in the abstract
Hazard ratio
0.76
95% CI 0.61–0.95
P = 0.01
Events by treatment group
High-normal potassium vs Standard care
HR 0.76 (95% CI 0.61–0.95); P = 0.01
Safety
Hospitalization for hyperkalemia or hypokalemia
- Similar in the two groups
Original publication
Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias. N Engl J Med. Published 29 August 2025. doi:10.1056/nejmoa2509542
Summarised from the published abstract; every number is checked against it