Wide QRS tachycardia caused by severe hyperkalaemia and digoxin intoxication

Goranitou, G.; Stavrianaki, Danai; Babalis, Dimitris

doi:10.2143/ac.60.4.2004994

Cited by 11 publications

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“…ECGs recorded from both the anaesthetized and the conscious animals did not show any significant changes in QRS durations, distinguishing the effect of the compound from that of general hyperkalemia. 24 Increasing potassium levels in patients suffering from congenital long QT2 has been shown effective in decreasing the QT interval, thereby decreasing the risk of Torsade de Pointes. 25 The associated increase in QRS duration, however, indicates that this is a nonselective way of increasing transmembranal potassium flux, which poses a potential risk to the patient by blocking conduction in the bundle of His and Purkinje fibers.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Effects of the IKr Agonist NS3623 on Cardiac Electrophysiology of the Guinea Pig

Hansen

Olesen²,

Rønn³

et al. 2008

Journal of Cardiovascular Pharmacology

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The long QT syndrome is characterized by a prolongation of the QT interval measured on the surface electrocardiogram. Prolonging the QT interval increases the risk of dangerous ventricular fibrillations, eventually leading to sudden cardiac death. Pharmacologically induced QT interval prolongations are most often caused by antagonizing effects on the repolarizing cardiac current called IKr. In humans IKr is mediated by the human ether-a-go-go related gene (hERG) potassium channel. We recently presented NS3623, a compound that selectively activates this channel. The present study was dedicated to examining the in vivo effects of NS3623. Injection of 30 mg/kg NS3623 shortened the corrected QT interval by 25 +/- 4% in anaesthetized guinea pigs. Accordingly, 50 mg/kg of NS3623 shortened the QT interval by 30 +/- 6% in conscious guinea pigs. Finally, pharmacologically induced QT prolongation by a hERG channel antagonist (0.15 mg/kg E-4031) could be reverted by injection of NS3623 (50 mg/kg) in conscious guinea pigs. In conclusion, the present in vivo study demonstrates that injection of the hERG channel agonist NS3623 results in shortening of the QTc interval as well as reversal of a pharmacologically induced QT prolongation in both anaesthetized and conscious guinea pigs.

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Section: Discussionmentioning

confidence: 99%

In Vivo Effects of the IKr Agonist NS3623 on Cardiac Electrophysiology of the Guinea Pig

Hansen

Olesen²,

Rønn³

et al. 2008

Journal of Cardiovascular Pharmacology

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“…In severe hyperkalemia (serum potassium > 7.0 mmol/L), sinus bradycardia, widening and flattening of P waves, conduction disturbances with prolongation of PR interval, wider QRS complex, Tawar bundle branch blocks, atrioventricular blockades (blockade of sodium channels) and ectopic electric activity can by seen. Sporadically ST depression with T wave inversions or ST elevation which may mimic acute myocardial infarction have been described [24][25][26][27][28][29][30][31][32][33] . The most severe hyperkalemia is represented by disappearance of P waves and sinus rhythm is replaced by emergency junction or ventricular rhythm with bizarre shape QRS.…”

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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Current awareness: Pharmacoepidemiology and drug safety

2006

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 20 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Wide QRS tachycardia caused by severe hyperkalaemia and digoxin intoxication

Cited by 11 publications

References 0 publications

In Vivo Effects of the IKr Agonist NS3623 on Cardiac Electrophysiology of the Guinea Pig

In Vivo Effects of the IKr Agonist NS3623 on Cardiac Electrophysiology of the Guinea Pig

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

Current awareness: Pharmacoepidemiology and drug safety

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