Abstract

Serum Potassium Levels and Atrial Fibrillation Recurrence After Percutaneous Catheter Ablation: A Comprehensive Literature Review

Background: Atrial Fibrillation (AF) ablation has become the gold standard treatment for symptomatic AF, but recurrence rates remain substantial at 20%-45%. While numerous biomarkers have been investigated as predictors of AF recurrence, the specific role of serum potassium levels and fluctuations during the perioperative period remains underexplored.

Objective: To systematically review the literature on the association between serum potassium levels, their variability, and AF recurrence following percutaneous catheter ablation, with particular focus on mechanistic insights, drug effects, procedural differences, and management targets.

Methods: A comprehensive search of PubMed and major academic databases was conducted using terms related to atrial fibrillation ablation, serum potassium levels, electrolyte imbalance, and recurrence outcomes.

Results: Limited but emerging evidence suggests that serum potassium levels may influence AF recurrence after ablation through multiple mechanisms involving ion channel function, cellular electrophysiology, and autonomic modulation. Mineralocorticoid receptor antagonists significantly affect potassium homeostasis and may influence AF outcomes. Different ablation techniques have varying impacts on perioperative electrolyte changes. Current evidence is insufficient to establish specific potassium management targets for post-ablation care.

Conclusion: While preliminary evidence suggests potential relationships between serum potassium levels and AF recurrence, dedicated large-scale prospective studies are needed to establish definitive associations, optimal management protocols, and evidence-based guidelines.

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