Is hypovitaminosis D (Vitamin D deficiency) related to cardiac arrhythmia?

From the Guidelines

Vitamin D deficiency is associated with an increased risk of cardiac arrhythmias, and maintaining adequate vitamin D levels is crucial for preventing arrhythmias. The relationship between hypovitaminosis D and cardiac arrhythmia is multifaceted, involving vitamin D's roles in calcium regulation, inflammation control, and cardiac muscle function. According to a study published in Circulation in 2015 1, vitamin D deficiency may exacerbate heart failure by decreasing functional capacity, increasing renin-angiotensin system activity, inflammation, and ventricular hypertrophy. Key points to consider include:

• Vitamin D deficiency is common, especially in older adults, with up to 90% having inadequate dietary intake 1.
• The bioactive form of vitamin D is synthesized in the skin, and its deficiency can be problematic, particularly in settings like skilled nursing facilities 1.
• Maintaining normal cardiac rhythm is also dependent on minerals like calcium and magnesium, which can be deficient due to loop diuretic agents 1.
• Daily multivitamin and mineral supplementation may be considered to prevent deficiencies, especially for residents taking loop diuretic agents 1. Given the potential for vitamin D deficiency to contribute to cardiac arrhythmias through various mechanisms, it is essential to maintain vitamin D levels above 30 ng/mL (75 nmol/L) to support overall cardiac health. If deficiency is suspected, testing and potential supplementation under medical supervision are recommended.

From the Research

Relationship Between Hypovitaminosis D and Cardiac Arrhythmia

• Hypovitaminosis D, or Vitamin D deficiency, has been linked to an increased risk of cardiovascular diseases, including cardiac arrhythmias 2, 3, 4.
• Several epidemiological and clinical studies have reported a close association between low vitamin D levels and major cardiovascular risk factors, such as coronary artery disease, heart failure, and cardiac arrhythmias 2, 4.
• The mechanism involved in the relationship between vitamin D deficiency and cardiac arrhythmias is linked to the transient outward current and the ultrarapid delayed rectifier K+ current densities, activated through the nuclear vitamin D receptor and Akt pathway 3.
• Atrial fibrillation, increased QT interval, and QT dispersion were the most common findings associated with vitamin D deficiency 3.
• Some studies have suggested a positive association between vitamin D deficiency and atrial fibrillation, while others have found no association or even an association between elevated vitamin D levels and atrial fibrillation 5.

Studies on Vitamin D Deficiency and Cardiac Arrhythmia

• A 2022 study published in Biomedicines found that vitamin D deficiency is associated with an increased risk of developing cardiac arrhythmias and sudden cardiac death 3.
• A 2021 review published in Nutrients summarized the currently available evidence supporting the link between vitamin D deficiency and major cardiovascular diseases, including cardiac arrhythmias 4.
• A 2015 study published in the International Journal of Cardiology found that vitamin D deficiency may be associated with atrial fibrillation, but the evidence was equivocal and further research was needed 5.
• A 2023 study published in the American Heart Journal investigated the effect of vitamin D3 supplementation on atrial fibrillation in generally healthy men and women, but the results are not specified in the provided text 6.