原发性心电疾病患者的低血钾与室性心律失常

目的分析原发性心电疾病患者低血钾的原因,探讨其低血钾与室性心律失常的关系。方法2003年8月~2005年6月共确定原发性心电疾病患者12例,8例在晕厥后或晕厥发作间歇期存在低钾血症,其中特发性心室颤动(简称室颤)1例,长QT综合征(LQTS)3例,B rugada综合征(BS)3例,多形性室性心动过速(简称室速)1例。结果8例共检测到低血钾23次,血钾浓度为2.92±0.42(1.8~3.34)mmol/L。4例低血钾可能是室速/室颤的诱因,4例低血钾与室速/室颤的关系不太明确。补钾治疗对3例LQTS与1例多形性室速患者有效,使1例BS患者晕厥发作减少。结论低血钾是原发性心电疾病患者室性心律失常发生的危险因素,应常规监测血钾浓度并维持其正常。

The relationship between hypokalemia and ventricular arrhythmias in patients with primary cardiac electric diseases

Objective To analyze the causes of hypokalemia of the patients with primary cardiac electric diseases,and its relation with ventricular arrhythmias.Methods The patients who had ventricular fibrillation(VF),syncope or presyncope were submitted to extensive evaluations,12 patients were diagnosed as primary cardiac electric diseases and 8 cases of them were found with hypokalemia.In these 8 patients,one patient suffered from idiopathic VF,3 from long QT syndrome,3 from Brugada syndrome,and the other one from polymorphic ventricular tachycardia(VT).Results hypokalemia (potassium less than 3.5 mmol/L) was measured for 23 times,and serum potassium concentration ranged 1.8 to 3.34(2.92±0.42) mmol/L in these 8 cases.Hypokalemia might contribute to the occurrence of VT/VF in 4 cases,but it was not clear in the other 4 cases.After correcting the serum potassium concentration,there was no further recurrence of malignant ventricular arrhythmia and syncope in 5 cases.Conclusions In the patients with primary cardiac electric diseases,hypokalemia should be regarded as a risk factor for VT/VF,and it must be monitored closely and kept on normal concentration.Chinese Journal of Cardiac Pacing and Electrophysiology,2006,20(1):25~27 ]