TY - JOUR
T1 - Association of Intravenous Potassium and Magnesium Administration With Spontaneous Conversion of Atrial Fibrillation and Atrial Flutter in the Emergency Department
AU - Cacioppo, Filippo
AU - Reisenbauer, Denise
AU - Herkner, Harald
AU - Oppenauer, Julia
AU - Schuetz, Nikola
AU - Niederdoeckl, Jan
AU - Schnaubelt, Sebastian
AU - Gupta, Sophie
AU - Lutnik, Martin
AU - Simon, Alexander
AU - Spiel, Alexander O
AU - Buchtele, Nina
AU - Domanovits, Hans
AU - Laggner, Anton N
AU - Schwameis, Michael
N1 - Publisher Copyright:
© 2022 Society of Exploration Geophysicists. All rights reserved.
PY - 2022/10/19
Y1 - 2022/10/19
N2 - IMPORTANCE: Whether the simultaneous intravenous administration of potassium and magnesium is associated with the probability of spontaneous conversion to sinus rhythm (SCV) in the acute treatment of atrial fibrillation (AF) and atrial flutter (AFL) is unknown.OBJECTIVE: To assess potassium and magnesium administration and SCV probability in AF and AFL in the emergency department.DESIGN, SETTING, AND PARTICIPANTS: A registry-based cohort study was conducted in the Department of Emergency Medicine of the Medical University of Vienna, Austria. All consecutive patients with AF or AFL were screened between February 6, 2009, and February 16, 2020.INTERVENTIONS: Intravenous administration of potassium, 24 mEq, and magnesium, 145.8 mg.MAIN OUTCOMES AND MEASURES: The primary outcome was the probability of SCV during the patient's stay in the emergency department. Multivariable cluster-adjusted logistic regression was used to estimate the association between potassium and magnesium administration and the probability of SCV.RESULTS: A total of 2546 episodes of nonpermanent AF (median patient age, 68 [IQR, 58-75] years, 1411 [55.4%] men) and 573 episodes of nonpermanent AFL (median patient age, 68 [IQR, 58-75] years; 332 [57.9%] men) were observed. In AF episodes, intravenous potassium and magnesium administration vs no administration was associated with increased odds of SCV (19.2% vs 10.4%; odds ratio [OR], 1.98; 95% CI, 1.53-2.57). In AFL episodes, in contrast, no association was noted for the probability of SCV with potassium and magnesium vs no administration (13.0% vs 12.5%; OR, 1.05; 95% CI, 0.65-1.69).CONCLUSIONS AND RELEVANCE: The findings of this registry-based cohort study on intravenous administration of potassium and magnesium suggest an increased probability of SCV in nonpermanent AF, but not AFL, during a patients' stay in the emergency department.
AB - IMPORTANCE: Whether the simultaneous intravenous administration of potassium and magnesium is associated with the probability of spontaneous conversion to sinus rhythm (SCV) in the acute treatment of atrial fibrillation (AF) and atrial flutter (AFL) is unknown.OBJECTIVE: To assess potassium and magnesium administration and SCV probability in AF and AFL in the emergency department.DESIGN, SETTING, AND PARTICIPANTS: A registry-based cohort study was conducted in the Department of Emergency Medicine of the Medical University of Vienna, Austria. All consecutive patients with AF or AFL were screened between February 6, 2009, and February 16, 2020.INTERVENTIONS: Intravenous administration of potassium, 24 mEq, and magnesium, 145.8 mg.MAIN OUTCOMES AND MEASURES: The primary outcome was the probability of SCV during the patient's stay in the emergency department. Multivariable cluster-adjusted logistic regression was used to estimate the association between potassium and magnesium administration and the probability of SCV.RESULTS: A total of 2546 episodes of nonpermanent AF (median patient age, 68 [IQR, 58-75] years, 1411 [55.4%] men) and 573 episodes of nonpermanent AFL (median patient age, 68 [IQR, 58-75] years; 332 [57.9%] men) were observed. In AF episodes, intravenous potassium and magnesium administration vs no administration was associated with increased odds of SCV (19.2% vs 10.4%; odds ratio [OR], 1.98; 95% CI, 1.53-2.57). In AFL episodes, in contrast, no association was noted for the probability of SCV with potassium and magnesium vs no administration (13.0% vs 12.5%; OR, 1.05; 95% CI, 0.65-1.69).CONCLUSIONS AND RELEVANCE: The findings of this registry-based cohort study on intravenous administration of potassium and magnesium suggest an increased probability of SCV in nonpermanent AF, but not AFL, during a patients' stay in the emergency department.
KW - Male
KW - Humans
KW - Aged
KW - Female
KW - Atrial Flutter/drug therapy
KW - Atrial Fibrillation/drug therapy
KW - Magnesium
KW - Cohort Studies
KW - Treatment Outcome
KW - Emergency Service, Hospital
KW - Potassium
UR - https://www.scopus.com/pages/publications/85140415169
U2 - 10.1001/jamanetworkopen.2022.37234
DO - 10.1001/jamanetworkopen.2022.37234
M3 - Journal article
C2 - 36260333
SN - 2574-3805
VL - 5
SP - e2237234
JO - JAMA network open
JF - JAMA network open
IS - 10
ER -