Hemodiafiltration and hemodialysis differently affect P wave duration and dispersion on the surface electrocardiogram

作者：Pall Alida; Czifra Arpad; Sebestyen Veronika; Becs Gergely; Kun Csaba; Balla Jozsef; Paragh Gyoergy; Lorincz Istvan; Pall Denes; Padra Tamas Janos; Agarwal Anupam; Zarjou Abolfazl; Szabo Zoltan^*

来源：International Urology and Nephrology, 2016, 48(2): 271-277.

DOI：10.1007/s11255-015-1144-4

• Hemodiafiltration
• Hemodialysis
• Atrial fibrillation
• P wave dispersion
• Arrhythmias

The incidence of atrial fibrillation is increased during hemodialysis (HD); however, the effects of hemodiafiltration (HDF) on atrial arrhythmias have not been evaluated. The prolongation of the P wave and P dispersion (Pd) can predict atrial arrhythmias.
Data from 30 patients receiving HDF over a period of 3 months were collected; the same group of patients was then evaluated during treatment with conventional HD for at least another 3 months. Electrolyte values were obtained, and surface electrocardiograms (ECG), echocardiography, and Holter ECGs were performed.
The duration of the P wave and Pd increased significantly during HD. The left atrial diameter decreased significantly only during HDF. During HDF, the left atrial cross diameter measured at the beginning of the session was positively correlated with the incidence of supraventricular premature beats (p = 0.011, r = 0.4556). The decrease in left atrial diameter during HDF was negatively correlated with the incidence of supraventricular premature beats (p = 0.016, r = -0.43). During HDF, the changes in sodium and Pd were significantly positively correlated (p < 0.05, r = 0.478). During HD, the changes in ionized calcium levels and Pd were positively correlated (p < 0.05, r = 0.377).
Our results suggest that HDF has a more beneficial effect on P wave duration and Pd than HD. The alterations in the ECG markers may be the result of the simultaneous occurrence of certain electrolyte imbalances and renal replacement methods.

• 出版日期2016-2
• 单位河北医科大学