Hyperkalemia probably reverses the antiarrhythmic effects of amiodarone - A case report

Sustained monomorphic ventricular tachycardia (VT) developed in a 58-year-o ld man with acute myocardial infarction and end-stage renal disease. Amioda rone was effective in preventing VT recurrence. Sustained VT was not induce d during an electrophysiologic study. However, VT recurred during accidenta l hyperkalemia, which was caused by the change of dialysis therapy from per itoneal dialysis to hemodialysis. VT subsided with correction of hyperkalem ia. Thereafter, VT did not recur as long as the serum potassium concentrati on was kept within the normal range. Several months later, the patient died suddenly because poor dietary compliance resulted in an increase in his po tassium concentration. This case suggests that hyperkalemia may reverse the potent antiarrhythmic effects of amiodarone.