AUTHOR=Skogestad Jonas , Aronsen Jan Magnus 

TITLE=Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy

JOURNAL=Frontiers in Physiology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2018.01500

DOI=10.3389/fphys.2018.01500

ISSN=1664-042X

ABSTRACT=<p>Routine use of diuretics and neurohumoral activation make hypokalemia (serum K<sup>+</sup> &lt; 3. 5 mM) a prevalent electrolyte disorder among heart failure patients, contributing to the increased risk of ventricular arrhythmias and sudden cardiac death in heart failure. Recent experimental studies have suggested that hypokalemia-induced arrhythmias are initiated by the reduced activity of the Na<sup>+</sup>/K<sup>+</sup>-ATPase (NKA), subsequently leading to Ca<sup>2+</sup> overload, Ca<sup>2+</sup>/Calmodulin-dependent kinase II (CaMKII) activation, and development of afterdepolarizations. In this article, we review the current mechanistic evidence of hypokalemia-induced triggered arrhythmias and discuss how molecular changes in heart failure might lower the threshold for these arrhythmias. Finally, we discuss how recent insights into hypokalemia-induced arrhythmias could have potential implications for future antiarrhythmic treatment strategies.</p>