Hyperkalemia in patients with left ventricular assist devices


Advocate Christ Medical Center


Both hypo- and hyperkalemia are associated with adverse events in heart failure patients. Their effects on patients with left ventricular assist devices (LVADs) remains unknown. The cohort included consecutive patients undergoing LVAD implantation between 2014 and 2018. In all, 170 patients (median age 56 years; 117 males) were stratified according to serum potassium levels 1 month after implantation into 3 groups: hypokalemia (<3.5 mEq/L; n=15), normokalemia (n=146), and hyperkalemia (>5.0 mEq/L; n=9). Compared with the normokalemia group, the adjusted hazard ratios for 1-year mortality were 0.91 (95% confidence interval [CI] 0.21-3.92) for hypokalemia and 4.14 (95% CI 1.47-11.65) for hyperkalemia. In the hyperkalemia group, the prevalence of renin-angiotensin-aldosterone system inhibitors decreased and serum potassium levels normalized following the first month. Hyperkalemia was associated with increased mortality during LVAD support. Management of serum potassium needs further investigation.

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