Alterations in Atrial Electrophysiology after Hemodialysis

概要

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Hemodialysis (HD) causes significant changes in hemodynamic status and metabolic milieu in chronic kidney disease patients (CKD). ECG parameters which reflect atrial electrophysiology, exemplified by p wave duration and p wave dispersion, may indirectly reflect these hemodynamic and metabolic changes. This study aimed to determine the effect of HD on the p wave duration (Pwd) and p wave dispersion (Pd) among patients with CKD. This is a prospective study of patients undergoing HD at the University of Santo Tomas Hospital. A 12 L ECG at a rate of 25 mm/sec was taken before and after hemodialysis. Pwd was measured with electronic digital caliper in all 12 leads. Pd, the difference between maximum and minimum Pwd, was measured. The maximum p wave duration (Pmax) and Pd were compared pre and post dialysis using paired students T-test. A total of 43 CKD patients with mean age of 55.23±14.3 were included in the study. Mean pre-dialysis Pmax was 72.44 plusmn; 6.58. Mean Post dialysis Pmax was 75.39±8.86. The mean difference between pre-dialysis and post dialysis Pmax was −2.95±5.55 (P 0.001). Mean pre-dialysis Pd was 15.51±5.64. Mean post dialysis Pd was 19.51±7.29. The mean difference between pre-dialysis and post-dialysis Pd was −4±6.2 (P 0.0001). Among CKD patients undergoing HD, in our study p wave duration and p wave dispersion significantly increased after hemodialysis indicating prolongation of atrial conduction time.