Hyperkalaemia and cardiac pacing

We read with great interest the superb review article by Littmann and Gibbs about the electrocardiographic manifestations of severe hyperkalemia [1]. Although the authors provide a detailed description of a wide range of ECG phenomena, the changes associated with hyperkalemia in patients with an implanted pacemaker (a relatively common clinical scenario nowadays) are barely mentioned. In addition to the loss of capture, there are two other ECG manifestations of this life-threatening condition that might help establish the diagnosis: The paced QRS complex increases in duration and the QRS complex exhibits an initial negative, shallow, and wide deflection followed by an rS deflection, both signs reflecting slower intramyocardial conduction [2].

Source: Journal of Electrocardiology - August 13, 2018 Category: Cardiology Authors: J ános Tomcsányi, Béla Bózsik Source Type: research