Sridharan M R, Horan L G, Flowers N C
Am Heart J. 1979 May;97(5):622-30. doi: 10.1016/0002-8703(79)90190-x.
We have demonstrated the progressive transmission delay in the A-V conduction system in graded hyperkalemia against a background of otherwise normal cations, and known blood gas relationships. This extends and further quantitates the work of others. We were unable to demonstrate sinoventricular conduction, as atrial activity was consistently recordable when surface P-waves disappeared. The His bundle appears to be the least susceptible conduction system structure to hyperkalemia. Finally, we have postulated the possible mechanism for the genesis of the sine wave, including loss of electrical gradient with resulting phase difference of QRS and T, associated with maintenance of His bundle activity with progressive, distal, Purkinje blockade.
在其他阳离子正常且已知血气关系的背景下，我们已经证明了在分级高钾血症时房室传导系统中传导延迟的进展。这扩展并进一步量化了其他人的研究成果。我们未能证明窦室传导，因为当体表P波消失时心房活动始终可记录。希氏束似乎是对高钾血症最不敏感的传导系统结构。最后，我们推测了正弦波产生的可能机制，包括电梯度丧失导致QRS波群和T波出现相位差，同时希氏束活动得以维持，而浦肯野纤维逐渐发生远端阻滞。
