Prominent bifid T waves observed in the QT prolongation caused by complete atrioventricular blockade in a hypokalemic diabetic patient

Sugako Oka-Manabe, Toru Maruyama, Ryuji Urae, Toshiaki Amamoto, Yoshiyuki Niho

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Abstract

A 63-year-old diabetic man was admitted with general fatigue. Electrocardiogram (ECG) on admission showed complete atrioventricular (AV) blockade associated with prominent bifid T waves. The second component of the bifid T waves was distinguished from U waves by the beat-to-beat varying bifidity and the nadir between the two components located at ≥1 mm above the isoelectric line. Range of absolute QT interval was 535 to 650 ms. Hypokalemia (3.6 mEq/L) was noted at admission. Partial restoration of the potassium level (3.9 mEq/L) prior to temporary ventricular demand pacing obscured the bifid T waves and attenuated the QT prolongation and dispersion to some extent (absolute QT interval ranging 520 to 620 ms). It was concluded that marked bradycardia caused by complete AV blockade (ie, a junctional escaped rhythm at a rate of 42 beats/min), hypokalemia, and underlying diabetes mellitus contributed in concert to the QT prolongation and dispersion leading to the prominent bifid T waves.

Original languageEnglish
Pages (from-to)289-292
Number of pages4
JournalJournal of Electrocardiology
Volume32
Issue number3
DOIs
Publication statusPublished - Jan 1 1999

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Hypokalemia
Bradycardia
Fatigue
Diabetes Mellitus
Potassium
Electrocardiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Prominent bifid T waves observed in the QT prolongation caused by complete atrioventricular blockade in a hypokalemic diabetic patient. / Oka-Manabe, Sugako; Maruyama, Toru; Urae, Ryuji; Amamoto, Toshiaki; Niho, Yoshiyuki.

In: Journal of Electrocardiology, Vol. 32, No. 3, 01.01.1999, p. 289-292.

Research output: Contribution to journalArticle

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