OBJECTIVE: To describe the clinical course of a patient with multiple ICD shocks in the setting of advanced renal failure and hyperkalemia. METHODS: The patient was brought to the Electrophysiology Laboratory where the ICD was interrogated. RESULTS: The patient was found to be hyperkalemic (serum potassium 7.6 mg/dl). Analysis of stored intracardiac electrograms from the ICD revealed "triple counting" (twice during his QRS complex and once during the T wave) and multiple inappropriate shocks. Correction of his electrolyte abnormality normalized his electrogram and no further ICD activations were observed. CONCLUSION: Electrolyte abnormalities can distort the intracardiac electrogram in patients with ICD's and these changes can lead to multiple inappropriate shocks.
OBJECTIVE: To describe the clinical course of a patient with multiple ICD shocks in the setting of advanced renal failure and hyperkalemia. METHODS: The patient was brought to the Electrophysiology Laboratory where the ICD was interrogated. RESULTS: The patient was found to be hyperkalemic (serum potassium 7.6 mg/dl). Analysis of stored intracardiac electrograms from the ICD revealed "triple counting" (twice during his QRS complex and once during the T wave) and multiple inappropriate shocks. Correction of his electrolyte abnormality normalized his electrogram and no further ICD activations were observed. CONCLUSION: Electrolyte abnormalities can distort the intracardiac electrogram in patients with ICD's and these changes can lead to multiple inappropriate shocks.
Authors: Slawomir Weretka; Jochen Michaelsen; Ruediger Becker; Christoph A Karle; Frederik Voss; Thomas Hilbel; Brigitte R Osswald; Malte L Bahner; Julia C Senges; Wolfgang Kuebler; Wolfgang Schoels Journal: Pacing Clin Electrophysiol Date: 2003-01 Impact factor: 1.976