Hyperkalemia induced failure of atrial and ventricular pacemaker capture

Kahloon, Mansha U.; Aslam, Ahmad Kamal; Aslam, Ahmed F.; Wilbur, Sabrina L.; Vasavada, Balendu C.; Khan, Ijaz A.

doi:10.1016/j.ijcard.2004.11.028

Cited by 26 publications

(15 citation statements)

References 5 publications

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“…A recent report by Kahloon et al in this journal showed failure of both atrial and ventricular pacemaker capture due to hyperkalemia [6]. Comparing their case report with our observation demonstrates that hyperkalemia with similar serum potassium levels can cause a variety of clinical and electrocardiographic findings: Instead of complete exit block with broad, non-stimulated QRS-complexes with a normal heart rate as described by Kahloon our patient displayed a 2:1 pacemaker exit block, resulting in bradycardia and syncope.…”

supporting

confidence: 73%

Pacemaker with 2:1 hyperkalemic ventricular exit block

Mischke¹,

Schimpf²,

Knackstedt³

et al. 2007

International Journal of Cardiology

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supporting

confidence: 73%

Pacemaker with 2:1 hyperkalemic ventricular exit block

Mischke¹,

Schimpf²,

Knackstedt³

et al. 2007

International Journal of Cardiology

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“…Hyperkalemia -induced failure of not only atrial capture with preserved ventricular pacing in a patient with a dual-chamber (DDD) pacemaker 35 but also failure of both the atrial and the ventricular pacemaker captures have been reported 36 . The ECG changes are strong impetus for urgent treatment of hyperkalemia.…”

Section: Hyperkalemia and Muscle And Myocardial Functionmentioning

confidence: 99%

Arrhythmias and ECG changes in life threatening hyperkalemia in older patients treated by potassium sparing drugs

Berková¹,

Berka²,

Topinková³

2014

BIOMED PAP

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Background. Severe hyperkalemia is a life threatening condition that can cause fatal rhythm disturbance and terminal heart arrest. The most common cause of hyperkalemia in older patients is that of iatrogenic medication-related etiology due to associated polymorbidity, polypharmacy and reduced reserve metabolic capacity. The aim of this paper is to increase awareness in the clinicians of the risk of hyperkalemia in elderly patients treated by potassium sparing drugs. Methods and Results. We present two case reports of hyperkalemia ≥ 9.0 mmol/L induced by potassium sparing medications with cardiac arrhythmias and severe ECG changes including atrial asystole, disturbance of intraventricular conduction and morphological changes such as tenting T waves and deformed wide QRS complexes. The most frequent causes of hyperkalemia in elderly patients are discussed and electrocardiogram changes and arrhythmias in hyperkalemia are analyzed, as well as their treatment and prevention. Conclusion. Potassium sparing drug therapy in older persons requires more frequent monitoring especially when drugs or their doses are changed, or during concomitant acute illness.

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“…Therefore, pacemaker exit block with increase of latency and loss of myocardial capture can be seen in the context of severe hyperkalemia (serum potassium > 7 mEq / L) [5]. It has been described the presence of exit block and loss of capture [6][7] in the context of severe hyperkalemia, but the presence of both due to moderate hyperkalemia has not yet been reported. Our patient showed a moderate acute hyperkalemia (6.2 mEq / L), which caused both, pacemaker exit block and capture failure.…”

Section: Case Reportmentioning

confidence: 99%