Impact of hemodialysis on P-wave amplitude, duration, and dispersion

Drighil, Abdenasser; Madias, John E.; El Mosalami, Hanane; El Badaoui, Nadia; Mouine, Bahija; Fadili, Wafae; Ramdani, Beenyouness and Bennis, Ahmed (2007) Impact of hemodialysis on P-wave amplitude, duration, and dispersion. Indian Pacing and Electrophysiology Journal, 7 (7). pp. 85-96. ISSN 0972-6292

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Atrial fibrillation (AF) is a frequent arrhythmia in patients undergoing hemodialysis (HD). P wave duration (PWdu) and P wave dispersion (PWdi) have been shown to be predictors of emerging AF in different clinical conditions. We sought to study the impact of HD on PWdu, PWdi, and P wave amplitude in a cohort of patients undergoing HD. Seventeen patients (8 men, 31±10 years) were studied. Echocardiography parameters, the sum of the amplitude of P waves in all 12 ECG leads (SP), mean PWdu, and PWdi, along with a host of other parameters (body weight, heart rate, electrolytes and hemoglobin/hematochrit) were measured 1/2h, before and after, HD. SP increased (11.8±3.9 vs 15.3±4.0 mm, p = 0.004), mean PWdu remained stable (82.7±11.1 vs 81.6±10.5 ms, p = 0.606), PWdi decreased (51.7±19.1 vs 41.7±19.1 ms, p = 0.03), and left atrial dimension decreased (37.96±3.90 vs 30.62±3.38 mm, p = 0.0001), after HD. The change in PWdi correlated with fluid removed by HD (r = -0.55, p = 0.022). Re-measurements of P-wave parameters in a random group of 11 of the 17 patients revealed augmented SP (p = 0.01), and stable mean PWdu (p = 0.36), and PWdi (p = 0.31), after HD. Fluid removed by HD leads to an increase in SP, a stable mean PWdu, and decrease (or stability on re-measurement in a subgroup of patients) in PWdi. Stability of PWdu may be due to the effects of augmentation of the P-wave amplitude and the reduction of the left atrial volume, canceling each other. Variability of PWdi may stem from the occasional impossibility to measure PWdu (or measure it correctly) in minute P-waves in certain ECG leads, which in turn profoundly affects the PWdi.

EPrint Type:Article
Uncontrolled Keywords:P-wave Duration, P-wave Dispersion, Hemodialysis, ECG, Electrical Impedance, Electrocardiography, Atrial Fibrillation, Arrhythmia
Subjects:Therapeutics > Renal Replacement Therapy
Cardiovascular Diseases > Heart Diseases > Arrhythmia > Atrial Fibrillation
Therapeutics > Sorption Detoxification
Diagnosis > Diagnostic Techniques and Procedures > Diagnostic Techniques, Cardiovascular > Heart Function Tests > Electrocardiography
-Journal Repositories > Indian Pacing and Electrophysiology Journal
Pathological Conditions, Signs and Symptoms > Pathologic Processes > Arrhythmia
ID Code:2684
Deposited By:Indian Pacing and Electrophysiology Journal
Deposited On:07 March 2008

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