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The first-in-human implantation of a leadless pacing system occurred already more than 10 years ago.1 The first-generation ventricular leadless pacemaker could provide only asynchronous ventricular pacing (ventricular, ventricular, inhibited [VVI], or ventricular, ventricular, inhibited, rate response [VVIR]), limiting its indications to patients with atrial fibrillation and severe bradycardia, those precluded for implantation of a transvenous pacemaker […]

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Mild hyperkalemia and low eGFR a tedious recipe for cardiac disaster in the elderly: an unusual reversible cause of syncope and heart block

Emad F. Aziz, Fahad Javed, Aleksandr Korniyenko, Balaji Pratap, Juan Pablo Cordova, Carlos L. Alviar, Eyal Herzog
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Published Online: Aug 7th 2018 Heart International 2011;6(2):e12 DOI: https://doi.org/10.4081/hi.2011.e12
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Abstract

Overview

Hyperkalemia affects the myocardial tissue
producing electrocardiographic abnormalities,
such as prolongation of the P-R interval, tall
peaked T waves, a reduction in the amplitude
and an increase in the duration of P wave, and
atrial and ventricular arrhythmias, including
variable degree heart blocks. Elderly patients
are particularly predisposed to developing
hyperkalemia and the associated abnormalities
due to an age-related reduction in
glomerular filtration rate and pre-existing
medical problems. Therefore, the impact of
aging on potassium homeostasis must be
taken into consideration, and preventive
measures, such as early recognition of possible
hyperkalemia in the geriatric population
treated with certain medications or supplements
must be investigated. The threshold for
cardiac arrhythmias in the elderly can be
lower than the general population. We report 3
unusual cases of mild hyperkalemia in elderly
patients presenting with hypotension, syncope
and variable degree heart blocks which
resolved spontaneously with the correction of
hyperkalemia.

Keywords

Elderly patients, hyperkalemia, renal failure, syncope, heart block.

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Article Information

Correspondence

Emad Aziz, Coordinator ACAP Program, St. Luke’s-Roosevelt Hospital Center, 1111 Amsterdam Avenue, New York, NY 10025, USA. E-mail: EA2168@columbia.edu

Received

2011-05-18T00:00:00

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