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Parameters of Cardiac Electrical Instability in Chronic Haemodialysis Patients

Received: 9 March 2015     Accepted: 17 March 2015     Published: 23 March 2015
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Abstract

Background: A large proportion of cardiovascular mortality in dialysis patients is caused by sudden death that is related to the dialysis procedure. Parameters of heart rate variability, P wave duration and dispersion and rate corrected QT and QT dispersion are readily used to assess cardiac electrical stability. However, there are relatively few data discussing the factors associated with arrhythmia in dialysis patients. Methods: The study included 30 patients on regular haemodialysis. All patients had full history taking (age, sex, duration of haemodialysis in months and smoking history), clinical examination, laboratory investigations (serum Mg, K, Na and complete blood picture), echocardiography and 24-hours Holter recording. Results: The study included 30 patient on regular haemodialysis (mean duration 30.9±13.2 months), 53.3% males with mean age 43.9±10.1 years. All ECG and Holter derived parameters showed statistically significant changes during haemodialysis. There were increase in P wave duration and dispersion, rate corrected QT interval and QT dispersion and decrease in heart rate variability, that are arrhythmogenic. Moreover, the incidence of both supraventricular and ventricular ectopics increased during dialysis. Smoking and long term dialysis were associated with more arrhythmia risk. Conclusions: Patients on regular haemodialysis are susceptible to cardiac arrhythmias. The process of haemodialysis itself is arrhythmogenic. Smoking and long term haemodialysis are associated with higher incidence of cardiac electrical instability.

Published in American Journal of Internal Medicine (Volume 3, Issue 3)
DOI 10.11648/j.ajim.20150303.11
Page(s) 78-85
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Haemodialysis, Arrhythmia, Smoking

References
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Cite This Article
  • APA Style

    Ahmed Abdel-Galeel, Lobna Abdel-Wahid, Samir Kamal Abdulhamid, Ahmed Obiedallah, Mohammed Aboel-Kassem Farghal Abdelmegid, et al. (2015). Parameters of Cardiac Electrical Instability in Chronic Haemodialysis Patients. American Journal of Internal Medicine, 3(3), 78-85. https://doi.org/10.11648/j.ajim.20150303.11

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    ACS Style

    Ahmed Abdel-Galeel; Lobna Abdel-Wahid; Samir Kamal Abdulhamid; Ahmed Obiedallah; Mohammed Aboel-Kassem Farghal Abdelmegid, et al. Parameters of Cardiac Electrical Instability in Chronic Haemodialysis Patients. Am. J. Intern. Med. 2015, 3(3), 78-85. doi: 10.11648/j.ajim.20150303.11

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    AMA Style

    Ahmed Abdel-Galeel, Lobna Abdel-Wahid, Samir Kamal Abdulhamid, Ahmed Obiedallah, Mohammed Aboel-Kassem Farghal Abdelmegid, et al. Parameters of Cardiac Electrical Instability in Chronic Haemodialysis Patients. Am J Intern Med. 2015;3(3):78-85. doi: 10.11648/j.ajim.20150303.11

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  • @article{10.11648/j.ajim.20150303.11,
      author = {Ahmed Abdel-Galeel and Lobna Abdel-Wahid and Samir Kamal Abdulhamid and Ahmed Obiedallah and Mohammed Aboel-Kassem Farghal Abdelmegid and Hanan Sharaf El-Deen Mohammed},
      title = {Parameters of Cardiac Electrical Instability in Chronic Haemodialysis Patients},
      journal = {American Journal of Internal Medicine},
      volume = {3},
      number = {3},
      pages = {78-85},
      doi = {10.11648/j.ajim.20150303.11},
      url = {https://doi.org/10.11648/j.ajim.20150303.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20150303.11},
      abstract = {Background: A large proportion of cardiovascular mortality in dialysis patients is caused by sudden death that is related to the dialysis procedure. Parameters of heart rate variability, P wave duration and dispersion and rate corrected QT and QT dispersion are readily used to assess cardiac electrical stability. However, there are relatively few data discussing the factors associated with arrhythmia in dialysis patients. Methods: The study included 30 patients on regular haemodialysis. All patients had full history taking (age, sex, duration of haemodialysis in months and smoking history), clinical examination, laboratory investigations (serum Mg, K, Na and complete blood picture), echocardiography and 24-hours Holter recording. Results: The study included 30 patient on regular haemodialysis (mean duration 30.9±13.2 months), 53.3% males with mean age 43.9±10.1 years. All ECG and Holter derived parameters showed statistically significant changes during haemodialysis. There were increase in P wave duration and dispersion, rate corrected QT interval and QT dispersion and decrease in heart rate variability, that are arrhythmogenic. Moreover, the incidence of both supraventricular and ventricular ectopics increased during dialysis. Smoking and long term dialysis were associated with more arrhythmia risk. Conclusions: Patients on regular haemodialysis are susceptible to cardiac arrhythmias. The process of haemodialysis itself is arrhythmogenic. Smoking and long term haemodialysis are associated with higher incidence of cardiac electrical instability.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Parameters of Cardiac Electrical Instability in Chronic Haemodialysis Patients
    AU  - Ahmed Abdel-Galeel
    AU  - Lobna Abdel-Wahid
    AU  - Samir Kamal Abdulhamid
    AU  - Ahmed Obiedallah
    AU  - Mohammed Aboel-Kassem Farghal Abdelmegid
    AU  - Hanan Sharaf El-Deen Mohammed
    Y1  - 2015/03/23
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ajim.20150303.11
    DO  - 10.11648/j.ajim.20150303.11
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 78
    EP  - 85
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20150303.11
    AB  - Background: A large proportion of cardiovascular mortality in dialysis patients is caused by sudden death that is related to the dialysis procedure. Parameters of heart rate variability, P wave duration and dispersion and rate corrected QT and QT dispersion are readily used to assess cardiac electrical stability. However, there are relatively few data discussing the factors associated with arrhythmia in dialysis patients. Methods: The study included 30 patients on regular haemodialysis. All patients had full history taking (age, sex, duration of haemodialysis in months and smoking history), clinical examination, laboratory investigations (serum Mg, K, Na and complete blood picture), echocardiography and 24-hours Holter recording. Results: The study included 30 patient on regular haemodialysis (mean duration 30.9±13.2 months), 53.3% males with mean age 43.9±10.1 years. All ECG and Holter derived parameters showed statistically significant changes during haemodialysis. There were increase in P wave duration and dispersion, rate corrected QT interval and QT dispersion and decrease in heart rate variability, that are arrhythmogenic. Moreover, the incidence of both supraventricular and ventricular ectopics increased during dialysis. Smoking and long term dialysis were associated with more arrhythmia risk. Conclusions: Patients on regular haemodialysis are susceptible to cardiac arrhythmias. The process of haemodialysis itself is arrhythmogenic. Smoking and long term haemodialysis are associated with higher incidence of cardiac electrical instability.
    VL  - 3
    IS  - 3
    ER  - 

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Author Information
  • Cardiology Department, Assiut University Hospitals, Assiut, Egypt

  • Internal Medicine Department, Assiut University Hospitals, Assiut, Egypt

  • Internal Medicine Department, Assiut University Hospitals, Assiut, Egypt

  • Internal Medicine Department, Assiut University Hospitals, Assiut, Egypt

  • Cardiology Department, Assiut University Hospitals, Assiut, Egypt

  • Internal Medicine Department, Assiut University Hospitals, Assiut, Egypt

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