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  • Title: Atrioventricular and intraventricular conduction in hyperkalemia.
    Author: Bashour T, Hsu I, Gorfinkel HJ, Wickramesekaran R, Rios JC.
    Journal: Am J Cardiol; 1975 Feb; 35(2):199-203. PubMed ID: 1119378.
    Abstract:
    Twelve patients exhibited electrocardiographic evidence of fascicular block during hyperkalemia. Isolated left posterior hemiblock occurred in four, isolated left anterior hemiblock in two, right bundle branch block with left anterior hemiblock in two, right bundle branch block with left posterior hemiblock in one, left bundle branch block with abnormal left axis deviation in two and advanced atrioventricular block in one. In all seven patients with sinus rhythm the P-R interval shortened after correction of hyperkalemia. Electrophysiologic studies using His bundle recording and atrial pacing in one patient revealed intraatrial conduction delay and marked prolongation of conduction time in the His-Purkinje system. It is concluded that conduction defects in the specialized intraventricular conduction system are common in hyperkalemia and result in electrocardiographic patterns of fascicular block.
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