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October 7, 1974

His Bundle Electrograms in a Patient With Hyperkalemia

Author Affiliations

From the Department of Medicine, Misericordia-Fordham Hospital Affiliation, Bronx, NY, New York (NY) Medical College.

JAMA. 1974;230(1):87-88. doi:10.1001/jama.1974.03240010055033

TO OUR knowledge, His bundle electrograms have never been obtained from a patient with hyperkalemia. We describe serial His bundle electrograms obtained from a patient with hyperkalemia caused by exogenous administration of potassium.

Report of a Case  An 80-year-old woman was admitted to Fordham Hospital because of shortness of breath. She was in excellent health until six months before admission when occasional bouts of dyspnea on exertion appeared. These episodes became more severe in the week preceding the hospitalization.On examination, her blood pressure was 160/80 mm Hg, her pulse rate was 90 beats per minute, with occasional premature beats, and her temperature was 38.2 C (100.8 F). Neck veins were prominent and rales were heard at both lung bases. The point of maximal cardiac impulse was in the sixth intercostal space beyond the midclavicular line. There were no murmurs or gallops. The liver was two fingerbreadths below the right