Hyperkalemia shortens repolarization; changes in the T wave provide the earliest clues to hyperpotassemia.
 - At K = 5.0 to 6.0 mEq/L, rapid repolarization causes peaked T waves (best seen in leads V2 to V4).
 - At K = 6.0 to 6.5 mEq/L, decrease in conduction causes prolonged PR and QT intervals.
 - At K = 6.5 to 7.0 mEq/L, P waves are diminished and ST segment may be depressed.
 - At K = 7.0 to 8.0 mEq/L, P waves disappear, QRS widens, and irregular idioventricular rhythm appears.
 - At K = 8.0 to 10.0 mEq/L, QRS merges with T wave to produce classic sine wave (QRS-T fusion – a sinusoidal waveform).
 - At K = 10.0 to 12.0 mEq/L, ventricular fibrillation and diastolic arrest occur.


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