Arrhythmias & electrophysiologyRandomised controlled trial
Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery
- Randomised controlled trial
- open-label
- non-inferiority
- multicentre (23 cardiac surgical centres, UK and Germany)
Authors' conclusion
For AFACS prophylaxis, supplementation only when serum potassium concentration fell below 3.6 mEq/L was noninferior to the current widespread practice of supplementing potassium to maintain a serum potassium concentration greater than or equal to 4.5 mEq/L.
Study context
- Population
- Patients with no history of atrial dysrhythmias scheduled for isolated coronary artery bypass grafting (CABG)
- Participants
- 1,690 patients
- Comparison
- Relaxed vs tight potassium control
- Primary endpoint
- Clinically detected and ECG-confirmed new-onset AF after cardiac surgery (AFACS)
- Follow-up
- First 120 hours after CABG or until hospital discharge, whichever first
Primary result
As reported in the abstract
Risk difference
1.7%
95% CI −2.6% to 5.9%
Events by treatment group
Relaxed vs Tight
risk difference 1.7% (95% CI −2.6% to 5.9%)
Non-inferiority margin 10 as printed, not drawn
Secondary outcomes
| Outcome | mean difference ($) (95% CI) | P value | |
|---|---|---|---|
| Per-patient cost for purchasing and administering potassium · significantly lower in Relaxed | 111.89 ($103.60-$120.19) | P < 0.001 | |
| −50050100150Difference, $ (linear scale) |
≥1 atrial fibrillation after cardiac surgery (AFACS) episode by any means or by ambulatory monitor alone, non-AFACS dysrhythmias, in-patient mortality, length of stay
- No difference between the groups
Original publication
Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery. JAMA. Published 24 September 2024. doi:10.1001/jama.2024.17888
Summarised from the published abstract; every number is checked against it