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Muscle Nerve. 2014 Sep;50(3):327-32. doi: 10.1002/mus.24225. Epub 2014 Aug 12.

Cardiac arrhythmias in hypokalemic periodic paralysis: Hypokalemia as only cause?

Author information

1
Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Abstract

It is unknown how often cardiac arrhythmias occur in hypokalemic periodic paralysis (HypoPP) and if they are caused by hypokalemia alone or other factors. This systematic review shows that cardiac arrhythmias were reported in 27 HypoPP patients. Cases were confirmed genetically (13 with an R528H mutation in CACNA1S, 1 an R669H mutation in SCN4A) or had a convincing clinical diagnosis of HypoPP (13 genetically undetermined) if reported prior to the availability of genetic testing. Arrhythmias occurred during severe hypokalemia (11 patients), between attacks at normokalemia (4 patients), were treatment-dependent (2 patients), or unspecified (10 patients). Nine patients died from arrhythmia. Convincing evidence for a pro-arrhythmogenic factor other than hypokalemia is still lacking. The role of cardiac expression of defective skeletal muscle channels in the heart of HypoPP patients remains unclear. Clinicians should be aware of and prevent treatment-induced cardiac arrhythmia in HypoPP.

KEYWORDS:

CACNA1S; HypoPP; SCN4A; cardiac arrhythmias; hypokalemia; hypokalemic periodic paralysis

PMID:
25088161
DOI:
10.1002/mus.24225
[Indexed for MEDLINE]

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