Effects of haemodialysis on maximum P wave duration and P wave dispersion

Szabó, Zoltán; Kakuk, G.; Fülöp, Tibor; Mátyus, János; Balla, József; Kárpáti, István; Juhász, Attila; Kun, Csaba; Karányi, Zsolt; Láng, István

doi:10.1093/ndt/17.9.1634

Cited by 50 publications

(59 citation statements)

References 17 publications

(15 reference statements)

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“…However, in one study, P-wave duration decreased and root mean square voltage of the final 20 ms of the filtered P wave decreased from the beginning to the end of dialysis, changes suggesting a reduced risk of AF after HD (53). Changes in electrolytes were associated with P-wave parameters in several studies (51,52), but associations with ultrafiltration appear more robust (50,51). On balance, this literature suggests that rapid ultrafiltration or other factors during HD acutely affect conduction in a way that could trigger AF but that effects rapidly attenuate after HD.…”

Section: Dialysis As a Triggermentioning

confidence: 95%

“…In several studies, intradialytic changes were prominent and were attenuated at the conclusion of dialysis (50,51). In others, changes were not detected or were seen only at the conclusion of dialysis and then quickly attenuated (52). However, in one study, P-wave duration decreased and root mean square voltage of the final 20 ms of the filtered P wave decreased from the beginning to the end of dialysis, changes suggesting a reduced risk of AF after HD (53).…”

Section: Dialysis As a Triggermentioning

confidence: 97%

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Arrhythmia and Sudden Death in Hemodialysis Patients

Charytan

Foley

McCullough

et al. 2016

Clinical Journal of the American Society of Nephrology

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Background Dialysis patients have high rates of cardiovascular morbidity and mortality, but data on arrhythmia burden, arrhythmia type, arrhythmia triggers, and the identity of terminal arrhythmias have historically been limited by an inability to monitor heart rhythm for prolonged periods.Objectives To investigate arrhythmia and its association with sudden death in dialysis-dependent ESRD, describe the potential for implantable devices to advance study of dialysis physiology, review the ethical implications of using implantable devices in clinical studies, and report on the protocol and baseline results of the Monitoring in Dialysis Study (MiD).Design, setting, participants, & measurements In this multicenter, interventional-observational, prospective cohort study, we placed implantable loop recorders in patients undergoing long-term hemodialysis. The proportion of patients experiencing clinically significant arrhythmias was the primary endpoint. For 6 months, we captured detailed data on the primary endpoint, symptomatic arrhythmias, other electrocardiographic variables, dialysis prescription, electrolytes, dialysis-related variables, and vital signs. We collected additional electrocardiographic data for up to 1 year.Results Overall, 66 patients underwent implantation in sites in the United States and India. Diabetes was present in 63.6% of patients, 12.1% were age $70 years, 69.7% were men, and 53.0% were black. Primary and secondary endpoint data are expected in 2016.Conclusions Cardiac arrhythmia is an important contributor to cardiovascular morbidity and mortality in dialysis patients, but available technology has previously limited the ability to estimate its true burden and triggers and to define terminal rhythms in sudden death. Use of implantable technology in observational studies raises complex issues but may greatly expand understanding of dialysis physiology. The use of implantable loop recorders in MiD is among the first examples of such a trial, and the results are expected to provide novel insights into the nature of arrhythmia in hemodialysis patients.

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Section: Dialysis As a Triggermentioning

confidence: 95%

Section: Dialysis As a Triggermentioning

confidence: 97%

Arrhythmia and Sudden Death in Hemodialysis Patients

Charytan

Foley

McCullough

et al. 2016

Clinical Journal of the American Society of Nephrology

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“…The duration of the P wave was measured by accepting the starting point of the P wave as the point at which the P wave cut the isoelectric line and the finishing point as the intersection of the end point of the P wave and the isoelectric line. P dispersion (Pd) was calculated as the difference between the maximum P wave duration and the minimum P wave duration [23].…”

Section: Electrocardiographic Measurementmentioning

confidence: 99%

QT dispersion and P wave dispersion in schizophrenia

Baykara

Yılmaz

Baykara

2018

Psychiatry and Clinical Psychopharmacology

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BACKGROUND: The difference between maximum QT (QTmax) and minimum (QTmin) on electrocardiography (ECG) is known as QT dispersion (QTd). An increase in QTd carries the risk of ventricular arrhythmia and subsequent death. P wave dispersion (Pd) shows the difference between maximum P (Pmax) and minimum P (Pmin). Prolonged P wave duration and an increase in Pd are a risk for irregular electrical transmission and atrial fibrillation. OBJECTIVES: The aim of this study was to examine QTd and Pd values which indicate atrial fibrillation and ventricular arrhythmia in schizophrenia patients with whom cardiovascular diseases (CVD) are seen at a higher rate than the general population.

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“…The speed of the impulse conduction in the myocardium depends on the activity of the immune system and the presence of ischaemia (4,6). Additional factors that can increase P d and that should be taken into account while interpreting results related with atrial conduction include endocrine disease, such as diabetes, thyroid hyperfunction, and the terminal stadium of renal failure (2,5,10,(21)(22)(23)25). In people, changes of Pwave dispersion were also observed during changes in the tension of the autonomic nervous system, for example while conducting the Valsalva maneuver (1) or in connection with panic attacks (24).…”

Section: Discussionmentioning

confidence: 99%

Physiological Values of P-Wave Dispersion in Silesian Breed Horses and Polish Primitive Horses

Michlik

Noszczyk-Nowak

Pasławska

et al. 2013

Bulletin of the Veterinary Institute in Pulawy

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Electrocardiographic examinations were performed on 45 Silesian breed horses (group K, 3-16-year-old, 16 stallions, 29 mares) and on 25 Polish Primitive breed horses (group P, 1.5-19-year-old, two stallions, six geldings, 17 mares). Einthoven and chest leads were used. P-wave dispersion was electronically evaluated. There was no correlation between P-wave dispersion and other ECG parameters, age, sex, body mass, or month of pregnancy. The average value of P-wave dispersion for all horses was 30.77 ms (SD 3.92 ms), however in particular groups it was: in group P -31.89 ms (SD 3.07 ms), and in group K -30.15 ms (SD 4.27 ms). The maximum value of P-wave dispersion in the studied population was 40 ms, in groups P and K -37,6 ms and 40 ms, respectively. The physiological value of P-wave dispersion for the group of horses was below 45 ms.

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Effects of haemodialysis on maximum P wave duration and P wave dispersion

Abstract: According to our results, ionic imbalance and dialysis itself may cause changes in P duration and dispersion simultaneously.

Cited by 50 publications

References 17 publications

Arrhythmia and Sudden Death in Hemodialysis Patients

Arrhythmia and Sudden Death in Hemodialysis Patients

QT dispersion and P wave dispersion in schizophrenia

Physiological Values of P-Wave Dispersion in Silesian Breed Horses and Polish Primitive Horses

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