Atrial pacing in the treatment of refractory ventricular tachycardia associated with hypokalemia

A rare case of hypokalemic ventricular tachycardia in a patient with thyrotoxic periodic paralysis

“…Physiologically, thyroid hormones, T3 and T4, affect regulatory and structural genes in cardiac myocytes, and more importantly, binding of T3-receptor complexes to DNA regulates gene expression of calcium cycling to control cardiac myocyte contraction. [5] In addition, thyroid hormones regulate calcium uptake into the sarcoplasmic reticulum during diastole through the sarcoplasmic reticulum Ca 2+ -ATPase and phospholamban. [5] Although thyroid hormones play an important role in the action potential and repolarization of cardiac myocytes, the predilection to tachyarrhythmias is multifactorial and is still suspected to be due to a hyperadrenergic and hypokalemic state.…”

“…[5] In addition, thyroid hormones regulate calcium uptake into the sarcoplasmic reticulum during diastole through the sarcoplasmic reticulum Ca 2+ -ATPase and phospholamban. [5] Although thyroid hormones play an important role in the action potential and repolarization of cardiac myocytes, the predilection to tachyarrhythmias is multifactorial and is still suspected to be due to a hyperadrenergic and hypokalemic state. [891011]…”

“…[2] A dangerous risk factor that leads to ventricular tachycardia (VT) is hypokalemia and must be corrected immediately. [3456] Hypokalemia prolongs repolarization and increases the slope of diastolic depolarization of automatic cells leading to tachycardia. [5] In patients with hyperthyroidism, an increase in thyroid hormones influences catecholamine binding and decreases activation at the tissue receptor site.…”

“…[3456] Hypokalemia prolongs repolarization and increases the slope of diastolic depolarization of automatic cells leading to tachycardia. [5] In patients with hyperthyroidism, an increase in thyroid hormones influences catecholamine binding and decreases activation at the tissue receptor site. [2] Although the pathophysiology of TPP is multifactorial and unclear, hypokalemia contributes to the development of paralysis in addition to VT.[456] In this case report, we discuss a patient with hyperthyroidism that presented with acute paralysis and VT due to profound hypokalemia.…”

Temporary neonatal atrial pacing through the umbilical venous route: A novel technique

“…[12] Overdrive atrial pacing using rates higher than the flutter rate is a standard treatment modality well documented and effective in most cases. [3] Also there are instances during cardiopulmonary resuscitation where atrial pacing may help, for example, in sinoatrial node dysfunction or depression due to metabolic cause,[4] or in a postasphyxia scenario. [5]…”