Hyperkalemia-Induced Accelerated Idioventricular Rhythm in a Patient with Acute Renal Failure

Figures & data

Figure 1. Twelve-lead ECG showing accelerated idioventricular rhythm in a patient with hyperkalemia.

Table 1. Electrocardiographic manifestations of serum hyperkalemia relative to serum potassium level.

Serum potassium level	Electrocardiographic manifestation
Mild hyperkalemia (5.5–7.5 mEq/L)	Narrow-based and tall-peaked T waves
	Fascicular blocks (LAFB, LPFB)
Moderate hyperkalemia (7.5–10.0 mEq/L)	Peaked T waves
	Prolonged PR interval (1° AV block)
	Decreased P-wave amplitude
	Widening of QRS complex
Severe hyperkalemia (>10 mEq/L)	Absence of P wave
	Atypical bundle branch block (LBBB and RBBB)
	VT and VF
	Eventual “sine-wave” pattern

Note: LAFB, left anterior fascicular block; LPFB, left posterior fascicular block; LBBB, left bundle branch block; RBBB, right bundle branch block; AV, atrioventricular; VT, ventricular tachycardias; and VF, ventricular fibrillation.