Alterations of atrial electrophysiology related to hemodialysis session: insights from a multiscale computer model

作者：Krueger Martin Wolfgang^*; Severi Stefano; Rhode Kawal; Genovesi Simonetta; Weber Frank Michael; Vincenti Antonio; Fabbrini Paolo; Seemann Gunnar; Razavi Reza; Doessel Olaf

来源：Journal of Electrocardiology, 2011, 44(2): 176-183.

DOI：10.1016/j.jelectrocard.2010.11.016

• Hemodialysis
• Atrial electrophysiology
• Multiscale cardiac modeling
• Patient-specific modeling
• P-wave

Background: The prevalence of atrial fibrillation is increased in patients with end-stage renal disease. Previous studies suggested that extracellular electrolyte alterations caused by hemodialysis (HD) therapy could be proarrhythmic.
Methods: Multiscale models were used for a consequent analysis of the effects of extracellular ion concentration changes on atrial electrophysiology. Simulations were based on measured electrolyte concentrations from patients with end-stage renal disease.
Results: Simulated conduction velocity and effective refractory period are decreased at the end of an HD session, with potassium having the strongest influence. P-wave is prolonged in patients undergoing HD therapy in the simulation as in measurements.
Conclusions: Electrolyte concentration alterations impact atrial electrophysiology from the action potential level to the P-wave and can be proarrhythmic, especially because of induced hypokalemia. Analysis of blood electrolytes enables patient-specific electrophysiology modeling. We are providing a tool to investigate atrial arrhythmias associated with HD therapy, which, in the future, can be used to prevent such complications.

• 出版日期2011-4