Clinical Chemistry, Vol 30, 754-757, Copyright © 1984 by American Association for Clinical Chemistry

Relationship of potassium and magnesium concentrations in serum to cardiac arrhythmias

JC Boyd, DE Bruns, JP DiMarco, NK Sugg and MR Wills

Low concentrations of potassium and magnesium in serum have been implicated in cardiac arrhythmias; the importance of mild hypokalemia or hypomagnesemia is uncertain. To investigate possible associations among use of diuretics, the concentration of these ions in serum, and the onset of clinically important arrhythmias, we reviewed records of 103 patients admitted to our Coronary Care Unit during three months and found mild to moderate hypokalemia and hypo- magnesemia in 18 and 24%, respectively. The significant correlation between the concentrations of magnesium and potassium in serum at admission (r = 0.27, p less than 0.007) remained constant in patients, whether they were receiving diuretics or not. Potassium concentrations were significantly lower (p less than 0.05) in patients receiving diuretics (3.93 mmol/L) than in those who were not (4.21 mmol/L), but the mean concentrations of magnesium did not differ significantly. Except for myocardial infarction, no single variable or combination of variables was highly predictive of cardiac arrhythmias in these patients. We conclude that there is no strong predictive relationship between mildly decreased concentrations of magnesium or potassium in serum and onset of cardiac arrhythmias.