Key result
Temporary endoventricular pacing restores renal blood flow and AV conduction in hyperkalemia-induced complete AV block.
Why the study?
Complete AV block due to hyperkalemia can occur despite the usual sensitivity differences among cardiac conduction tissues, but cases without QRS prolongation are not well characterized.
Case Report (n=1)
Hyperkalemia can cause complete AV block without QRS prolongation, which can be successfully managed with temporary pacing to allow renal potassium excretion and conduction recovery.
Should not change practice for hyperkalemic AV block; hypothesis-generating for pacing in atypical presentations.
Purkinje and ventricular myocardial fibers are thought to be more sensitive to hyperkalemia than sinoatrial and atrioventricular (AV) nodes, although complete AV block due to hyperkalemia can occur. We describe a case in which hyperkalemia in a patient affected by renal failure is responsible for complete AV block without QRS complex prolongation. Temporary endoventricular pacing was essential in restoration of adequate renal blood flow and excretion of exceeding serum potassium with subsequent normalization of AV conduction.
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Tiberti et al. (1998) conducted a case report in Hyperkalemia and renal failure with complete AV block (n=1). Temporary endoventricular pacing was evaluated on Restoration of adequate renal blood flow, excretion of exceeding serum potassium, and normalization of AV conduction. Temporary endoventricular pacing successfully restored adequate renal blood flow and normalized AV conduction in a patient with hyperkalemia-induced complete AV block without QRS prolongation.
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