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↑ Bashour T, Hsu I, Gorfinkel HJ, Wickramesekaran R, Rios JC (1975).Unknown parameter |month= ignored ( help) CS1 maint: Multiple names: authors list ( link) "Sinus arrest and moderate hyperkalemia". ↑ Bonvini RF, Hendiri T, Anwar A (2006).An electrocardiographic sine wave in hyperkalemia". CS1 maint: Multiple names: authors list ( link) CS1 maint: PMC format ( link) CS1 maint: Multiple names: authors list ( link) "Retrospective review of the frequency of ECG changes in hyperkalemia". ↑ Montague BT, Ouellette JR, Buller GK (2008)."Profound hyperkalemia without electrocardiographic manifestations". ↑ Szerlip HM, Weiss J, Singer I (1986)."Muscular paralysis and ventilatory failure caused by hyperkalaemia". Shown below is an EKG demonstrating peaked T waves, loss of P wave and wide QRS complex depicting hyperkalemia. Hyperkalemia can lead to ventricular fibrillation, and subsequent asystole, if the cardiac myocardium was not stabilized.The result of the fusion of the QRS interval and T wave is reflected by a sine wave pattern.As potassium level continues to rise, the QRS interval will continue to widen until it fuses with the T wave.Accelerated junctional rhythm occurs when junctional pacemaker begin firing electrical impulses as a result of complete disruption of the sinoatrial conduction.Moderate or severe hyperkalemia can cause sinus arrest causing accelerated junctional rhythm.dinn accelrated junctional rhythmconditithe S ndecal imp.
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Sinus Arrest with Accelerated Junctional Rhythm The absence of P wave along with wide QRS can be confused with ventricular tachycardia.The SA node, continues to fire despite hyperkalemia and this results in atriventricular delay and responsible for absent p waves.le tlemia thanhe atr nduction.Decreased P wave amplitude occurs when K is > 7.0 meq/L with subsequent absence of P waves when K is > 8.8 meq/L.As the serum potassium level rises, the QRS complexes may resemble sine waves.There is a modest correlation of the QRS duration with serum potassium level.Another manifestation of interventricular conduction delay is PR segment prolongation.
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