Diuretic-induced hypokalemia and cardiac arrhythmias

Premature ventricular contractions have long been recognized as a complication of severe diuretic-induced hypokalemia. Likewise, diuretic-induced mild hypokalemia is known to have an arrhythmogenic potential in patients who are concurrently being treated with digitalis compounds. Recent studies using exercise and ambulatory monitoring of the electrocardiogram suggest that diuretic-induced premature ventricular contractions may be a more common phenomenon than was previously recognized. The risk of this form of ventricular ectopic activity is controversial. However, the available data are substantial enough to warrant some precautions on the part of the clinician.