{"id":5995,"date":"2025-09-05T09:39:59","date_gmt":"2025-09-05T07:39:59","guid":{"rendered":"https:\/\/rythmologie.fr\/index\/?p=5995"},"modified":"2025-09-05T10:37:30","modified_gmt":"2025-09-05T08:37:30","slug":"le-maintien-dune-kaliemie-45-mmol-l-permet-il-de-diminuer-les-arythmies-ventriculaires","status":"publish","type":"post","link":"https:\/\/rythmologie.fr\/index\/le-maintien-dune-kaliemie-45-mmol-l-permet-il-de-diminuer-les-arythmies-ventriculaires\/","title":{"rendered":" Le maintien d\u2019une kali\u00e9mie > 4,5 mmol.L ..."},"content":{"rendered":"<h1>Le maintien d\u2019une kali\u00e9mie &gt; 4,5 mmol.L permet-il de diminuer les arythmies ventriculaires ?<\/h1>\n<p>Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias (The POTCAST study)<br \/>\nPr\u00e9sent\u00e9e par Christian Jons, Rigshospitalet, Copenhagen, Denmark<\/p>\n<p><strong>Messages cl\u00e9s <\/strong><\/p>\n<ul>\n<li>Chez les patients ayant une cardiopathie et \u00e9quip\u00e9s d\u2019un d\u00e9fibrillateur cardiaque, le maintien d\u2019une kali\u00e9mie entre 4,5 et 5mmol\/L permet de diminuer le risque de th\u00e9rapies appropri\u00e9 mais pas le risque de d\u00e9c\u00e8s.<\/li>\n<\/ul>\n<p><strong>Introduction<\/strong><\/p>\n<p>L\u2019hypokali\u00e9mie et m\u00eame une kali\u00e9mie normale -basse est associ\u00e9e \u00e0 un risque d\u2019arythmies cardiaques chez les patients ayant une maladie cardiovasculaire.<br \/>\nLe but de cette \u00e9tude \u00e9tait d\u2019\u00e9valuer si une strat\u00e9gie d\u2019augmentation du potassium \u00e0 un niveau normal-haut \u00e9tait associ\u00e9 \u00e0 moins d\u2019arythmie.<\/p>\n<p><strong>M\u00e9thodologie et r\u00e9sultats<\/strong><\/p>\n<ul>\n<li><strong>Population<\/strong><br \/>\nLes crit\u00e8res d\u2019inclusion \u00e9taient les patients ayant un d\u00e9fibrillateur cardiaque et un taux de potassium \u22644.3 mmol\/L \u00e0 l\u2019entr\u00e9e.<\/li>\n<li><strong>Design<\/strong><br \/>\nEssai contr\u00f4l\u00e9 randomis\u00e9 comparant :<br \/>\n&#8211; une strat\u00e9gie permettant d\u2019obtenir une kali\u00e9mie normale haute (kali\u00e9mie entre 4,5 et 5 mmol\/L) (par des suppl\u00e9mentations potassiques , un antagoniste des r\u00e9cepteurs aux min\u00e9ralocortico\u00efdes, et\/ou des conseils di\u00e9t\u00e9tiques)<br \/>\n&#8211; vs l\u2019absence de strat\u00e9gie pour atteindre une kali\u00e9mie normale haute.<\/li>\n<li><strong>Crit\u00e8res de jugement<\/strong><br \/>\nLe crit\u00e8re de jugement principal combinait l\u2019association de la tachycardie ventriculaire soutenue, th\u00e9rapie appropri\u00e9e, hospitalisation pour arythmie ou insuffisance cardiaque ou d\u00e9c\u00e8s toute cause.<\/li>\n<li><strong>R\u00e9sultat principal<\/strong><br \/>\n600 patients ont \u00e9t\u00e9 randomis\u00e9s dans chaque groupe. La dur\u00e9e de suivi moyen \u00e9tait de 39,6 mois. Le crit\u00e8re de jugement principal est survenu dans 22,7% du groupe kali\u00e9mie normale haute et 29,2% dans le groupe contr\u00f4le.<br \/>\nL\u2019incidence d\u2019hospitalisation pour hypokali\u00e9mie ou hyperkali\u00e9mie \u00e9tait similaire dans les 2 groupes. Il n\u2019y avait pas de diff\u00e9rence concernant la mortalit\u00e9.<\/li>\n<\/ul>\n<p><strong>Conclusion<\/strong><\/p>\n<p>Chez les patients ayant un d\u00e9fibrillateur cardiaque et une cardiopathie, le maintien d\u2019une kali\u00e9mie normale haute \u00e9tait associ\u00e9 \u00e0 un risque plus faible de th\u00e9rapie par le d\u00e9fibrillateur, hospitalisation non planifi\u00e9e pour arythmie ou insuffisance cardiaque ou d\u00e9c\u00e8s.<br \/>\nCependant cette strat\u00e9gie n\u2019avait aucun effet sur la mortalit\u00e9 toute cause prise s\u00e9par\u00e9ment.<\/p>\n<p style=\"text-align: right;\"><em>Auteur : Pr Rodrigue GARCIA, CHU Poitiers<\/em><\/p>\n<p><strong>Visuels cl\u00e9s<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-5996 size-full\" src=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-1.png\" alt=\"\" width=\"554\" height=\"309\" srcset=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-1.png 554w, https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-1-300x167.png 300w\" sizes=\"auto, (max-width: 554px) 100vw, 554px\" \/><\/p>\n<p style=\"text-align: left;\"><strong><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-5997 size-full\" src=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-2.png\" alt=\"\" width=\"554\" height=\"310\" srcset=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-2.png 554w, https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-2-300x168.png 300w\" sizes=\"auto, (max-width: 554px) 100vw, 554px\" \/><\/strong><\/p>\n<p style=\"text-align: left;\"><strong><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-5998 size-full\" src=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-3.png\" alt=\"\" width=\"554\" height=\"307\" srcset=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-3.png 554w, https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-3-300x166.png 300w\" sizes=\"auto, (max-width: 554px) 100vw, 554px\" \/><\/strong><\/p>\n<p style=\"text-align: left;\"><strong><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-5999 size-full\" src=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-4.png\" alt=\"\" width=\"554\" height=\"308\" srcset=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-4.png 554w, https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-4-300x167.png 300w\" sizes=\"auto, (max-width: 554px) 100vw, 554px\" \/><\/strong><\/p>\n<p style=\"text-align: left;\"><strong><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-6000 size-full\" src=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-5.png\" alt=\"\" width=\"554\" height=\"311\" srcset=\"https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-5.png 554w, https:\/\/rythmologie.fr\/index\/wp-content\/uploads\/2025\/09\/POTCAST-5-300x168.png 300w\" sizes=\"auto, (max-width: 554px) 100vw, 554px\" \/><\/strong><\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: left;\"><strong>R\u00e9f\u00e9rences bibliographiques<\/strong><\/p>\n<p>J\u00f8ns C, Zheng C, Winsl\u00f8w U, Danielsen E et al.; POTCAST Study Group. Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias. N Engl J Med2025 Aug 29. PMID: 40879429 DOI: 10.1056\/NEJMoa2509542<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Le maintien d\u2019une kali\u00e9mie &gt; 4,5 mmol.L permet-il de diminuer les arythmies ventriculaires ? Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias (The POTCAST study) Pr\u00e9sent\u00e9e par Christian Jons, Rigshospitalet, Copenhagen, Denmark Messages cl\u00e9s Chez les patients ayant une cardiopathie et \u00e9quip\u00e9s d\u2019un d\u00e9fibrillateur cardiaque, le maintien d\u2019une kali\u00e9mie entre 4,5&hellip;<\/p>\n","protected":false},"author":2,"featured_media":6020,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[51,61,22],"tags":[],"class_list":["post-5995","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-congres","category-esc-2025","category-articles","category-51","category-61","category-22","description-off"],"_links":{"self":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/5995","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/comments?post=5995"}],"version-history":[{"count":2,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/5995\/revisions"}],"predecessor-version":[{"id":6002,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/5995\/revisions\/6002"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media\/6020"}],"wp:attachment":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media?parent=5995"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/categories?post=5995"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/tags?post=5995"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}