Early extracellular potassium accumulation is a key driver of the electrophysiological changes, such as ST elevation and reentry, seen in acute myocardial ischemia.
Supports K+ modulation as potential antiarrhythmic strategy in early ischemia; leaves open efficacy in clinical trials.
The cellular events leading to clinical manifestations of acute (less than 30 minutes) ischemia are discussed, with emphasis on the role of early extracellular K + accumulation and its effect on sodium current kinetics, which causes changes in excitability, conduction, and refractory periods. These are the cellular phenomena responsible for ST elevation, reentry, and enhanced automaticity, which characterize the early clinical events in ischemia. During this early period, A TP levels are normal and calcium metabolism appears normal.
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Harry A. Fozzard (1985) studied this question.
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