Potassium and the monophasic action potential, electrocardiogram, conduction and arrhythmias

Fisch, Charlés; Knoebel, Suzanne B.; Feigenbaum, Harvey; Greenspan, Kalman

doi:10.1016/s0033-0620(66)80029-4

Cited by 111 publications

(29 citation statements)

References 127 publications

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“…During potassium infusion the T waves suddenly became peaked and the amplitude of the QRS diminished, indicating that the potassium was being infused too quickly. 9 Within a couple of minutes of slowing down the infusion of potassium, the ECG returned to normal with a serum potassium of 4.6 mEq./L. Similar changes were observed in other patients when potassium was being infused too quickly.…”

Section: Resultssupporting

confidence: 65%

Electrocardiogram as a Guide to Potassium Replacement in Diabetic Ketoacidosis

et al. 1974

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Twenty-three patients in severe diabetic ketoacidosis were followed by continuous electrocardiographic monitoring using Lead II of the electrocardiogram throughout their course of treatment. Frequent serum potassium determinations were carried out and correlated with the ECG changes. On admission to hospital the electrocardiogram of ketoacidotic patients showed varied T wave patterns often with little correlation to the serum potassium, but the two patients who were initially hypokalemic were identified from the ECG appearances. Following the infusion of fluids alone the serum potassium fell with accompanying T wave and ST segment changes while the administration of potassium reversed these abnormalities. Although the electrocardiogram is not a substitute for serum potassium determinations, it is a useful guide to potassium replacement in diabetic ketoacidosis. In the successful management of this diabetic emergency the achievement and maintenance of a normal ECG, by means of early and continuous administration of potassium in the infused fluids, should be an important objective of treatment. DIABETES23:610-15, July, 1974.

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Section: Resultssupporting

confidence: 65%

Electrocardiogram as a Guide to Potassium Replacement in Diabetic Ketoacidosis

et al. 1974

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“…Hypokalemia is known to be a risk factor for acute heart failure, ventricular arrhythmia, and sudden death [33,34]. Since serum potassium concentration has a key role in determining the cell membrane resting potential of cardiac myocytes, decreased serum potassium concentration causes arrhythmia [35] by affecting the impulseconduction system and cardiac contraction [36]. Hypokalemia has also been shown to induce dilated cardiomyopathy [37] and cardiac hypertrophy by direct mechanisms [38].…”

Section: Discussionmentioning

confidence: 99%

Hypokalemia, Diabetes Mellitus, and Hypercortisolemia are the Major Contributing Factors to Cardiac Dysfunction in Adrenal Cushing's Syndrome

et al. 2009

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Abstract. Although cardiovascular complications are the major determinant of the prognosis of Cushing's syndrome (CS), factors contributing to the cardiovascular lesions are still unclear. We investigated clinical factors determining cardiac function in patients with adrenal CS. Fifty patients with adrenal CS were studied. Patients were divided into 3 groups based on their NYHA classification and electrocardiographic (ECG) findings: group A with NYHA grade 0 and normal eCg, group b with nyHA grade I and abnormal eCg, and group C with nyHA grade II or higher. Clinical and echocardiographic findings were compared between the groups. Heart failure of grade I or higher was seen in 40% and grade II or higher was seen in 8% of the patients. Age, HbA1c, and prevalence of diabetes mellitus were positively correlated and serum potassium levels were negatively correlated with the severity of cardiac dysfunction. Decreased ejection fraction (EF) and the ratio of the peak to late transmittal filling velocities (E/A), and increased left ventricular mass index (LVMI) were frequently observed. Multivariate analysis demonstrated that serum potassium and HbA1c levels were independent factors contributing to eF, while serum potassium and cortisol levels were independent factors contributing to LVMI. These results clearly demonstrated that hypokalemia, diabetes mellitus, and hypercortisolemia are the major contributing factors to cardiac dysfunction in adrenal CS. Strict control of these conditions is warranted for the prevention of cardiac dysfunction in adrenal CS.

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“…Hypokalemia causes cellular hyperpolarity, increases resting potential, hastens depolarization, and increases automaticity and excitability [31,32]. Because cardiac repolarization relies on K + influx, hypokalemia lengthens the action potential and increases QT dispersion reflecting electrical inhomogeneity.…”

Section: Effect Of Hypokalemia In Hfmentioning

confidence: 99%