Abstract 12223: Prognostic Significance of Hyperkalemia in Chronic Heart Failure Patients With Implantable Cardioverter-Defibrillator

Introduction: Hyperkalemia is a common morbidity in heart failure (HF) patients and potentially leads to the lethal arrhythmia. However, whether hyperkalemia is associated with worse outcome in chronic HF patients with Implantable Cardioverter-Defibrillator (ICD) is unknown. Methods: This was a retrospective review of all HF patients (n=532) who had been implanted with ICD from 2008 to 2017 at our institution. We examined the association of hyperkalemia with all-cause mortality, hospitalization for HF and appropriate ICD therapy for ventricular tachycardia or ventricular fibrillation. Results: Hyperkalemia (≥5.0 mmol/L) were present in 48 patients (9%) and normokalemia (3.5 to 4.9 mmol/L) in 476 patients (89%). The median potassium levels were 5.2 mmol/L [interquartile range (IQR) 5.0-5.3] in the hyperkalemia group and 4.2 mmol/L (IQR 4.0-4.5) in the normokalemia group. Mean follow-up was 1,602 days. The Kaplan-Meier analysis showed there were no significant between-group differences in all-cause mortality and appropriate ICD therapy for ventricular tachycardia or ventricular fibrillation (log-rank P = 0.10 and P = 0.97, respectively). However, in hyperkalemia group there was a significant higher rate of hospitalization for HF (log-rank P = 0.0002). Cox regression analysis after adjustment for significant predictors demonstrated that hyperkalemia was independently associated with hospitalization for HF compared with normokalemia. Conclusion: In chronic HF patients with ICD, hyperkalemia is an independent predictor of hospitalization for HF, but hyperkalemia is not associated with increased risk of ventricular tachycardia or ventricular fibrillation.