Hypokalemia Induced Ventricular Arrhythmia In Heart Failure Patient With Complete Revascularization: A Case Report

Icmi Dian Rochmawati, Ardian Rizal, Mohammad Saifur Rohman, Indra Prasetya



Sudden mortality due to persistent VT or VF accounted for around half of all fatalities in these high-risk individuals. Myocardial ischemia, acute heart failure, electrolyte abnormalities, hypoxia, and drug-related arrhythmogenicity are all risk factors for electrical storms. The most common electrolyte imbalance is hypokalemia.

Case illustration:

A 54-year-old man was readmitted to ER with palpitations and chest pain. The patient's heart rate was recorded as sinus bradycardia however, shortly the patient developed ventricular tachycardia of approximately 300 beats per minute (bpm) and unstable. Although multiple synchronized cardioversion dosage was administered, the VT reoccurred again. Complete revascularization was demonstrated at his most recent catheterization three months ago. His potassium in the serum was 2.88 mmol/L and corrected with drip KCl. The patient's potassium levels were then normalized stable for the remainder of their hospital stay.


Careful medication reconciliation is critical for avoiding the potentially fatal cardiovascular effects of severe hypokalemia. Patients with CHF are more likely to have life-threatening hypokalemia and ventricular arrhythmias. The phenotypic expression of ventricular tachycardia in HF results from alterations in neurohormonal signaling, structural remodeling, and electrophysiology.


Hypokalemia, Ventricular Arrhythmia, Heart Failure

Full Text:



Bhar-Amato J, Davies W, Agarwal S. Ventricular arrhythmia after acute myocardial infarction: “The perfect storm.” Arrhythmia Electrophysiol Rev. 2017;6(3):134-139. doi:10.15420/aer.2017.24.1

Gorenek B, Lundqvist CB, Terradellas JB, et al. Cardiac arrhythmias in acute coronary syndromes: position paper from the joint EHRA, ACCA, and EAPCI task force. Eur Hear journal Acute Cardiovasc care. 2015;4(4):386. doi:10.1177/2048872614550583

Skogestad J, Aronsen JM. Hypokalemia-induced arrhythmias and heart failure: New insights and implications for therapy. Front Physiol. 2018;9(NOV):1-11. doi:10.3389/fphys.2018.01500

Fargaly H, Schultz RJ, Chung UY, Rossi NF. Hypokalemia-Induced Life-Threatening Arrhythmia in a Patient With Congestive Heart Failure. Cureus. 2023;15(2). doi:10.7759/cureus.34971

Sella G, Kracoff SL. Resetting of Cardiac Ventricular Tachycardia Storm with Intravenous Potassium Chloride: A Case Report. Case Reports Clin Med. 2018;07(02):154-161. doi:10.4236/crcm.2018.72013

Alvarez CK, Cronin E, Baker WL, Kluger J. Heart failure as a substrate and trigger for ventricular tachycardia. J Interv Card Electrophysiol. 2019;56(3):229-247. doi:10.1007/s10840-019-00623-x

Kardalas E, Paschou SA, Anagnostis P, Muscogiuri G, Siasos G, Vryonidou A. Hypokalemia: A clinical update. Endocr Connect. 2018;7(4):R135-R146. doi:10.1530/EC-18-0109

Hoffmann G, Lutter G, Cremer J. Durability of bioprosthetic cardiac valves. Dtsch Arztebl. 2008;105(8):143-148. doi:10.3238/arztebl.2008.0143

Philips DA, Bauch TD. Rapid Correction of Hypokalemia in a Patient with an Implantable Cardioverter-Defibrillator and Recurrent Ventricular Tachycardia. J Emerg Med. 2010;38(3):308-316. doi:10.1016/j.jemermed.2007.06.019

DOI: https://doi.org/10.21776/ub.hsj.2023.004.04.7


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