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Intern Emerg Med (2012) 7:193194 DOI 10.1007/s11739-011-0732-2
CE - LETTER TO THE EDITOR
Hypokalemia-induced TU fusion
Hesham R. Omar
Received: 3 October 2011 / Accepted: 8 November 2011 / Published online: 3 December 2011 SIMI 2011
To the Editor
I have read with interest the article by Baugh and Reisner [1] entitled QTc pseudo-prolongation in a recent issue of the journal. The Electrocardiograms presented in this case clearly demonstrate the phenomenon of TU fusion. While a prominent U wave is characteristic of hypokalemia, a prolonged QT interval is another feature encountered in these patients. Trojak et al. [2] found a signicant inverse correlation between serum potassium levels and QTc interval (P = 0.005). Fukui et al. [3] has studied risk factors for QTc prolongation among 100 patients admitted within 24 h after the onset of stroke, and concluded that hypokalemia is an independent risk factor for severe QT prolongation.
TU fusion is seen in electrolyte abnormalities, CNS disease, e.g. subarachnoid hemorrhage, congenital and hereditary long QT syndromes, and with drugs prolonging the QT interval. Hypokalemia as a cause of TU fusion has been previously reported by Weaver...