Increases in P-wave duration and dispersion after hemodialysis are totally (or partially) due to the procedure-induced alleviation of the body fluid overload: A hypothesis with strong experimental support

Annals of Noninvasive Electrocardiology

Volumn 10, Issue 2, 2005, Pages 129-133

  Madias, John E ^a,b  

^a NEW YORK UNIVERSITY   (United States)

^b ELMHURST HOSPITAL CENTER   (United States)

Author keywords

Anasarca; ECG; ECG transfer impedance; Hemodialysis; P wave dispersion; P wave duration

Indexed keywords

ARTICLE; BODY FLUID; BODY WEIGHT; ELECTROCARDIOGRAPHY; ELECTROLYTE BALANCE; EXPERIMENT; HEART PROARRHYTHMIA; HEMODIALYSIS; HYPOTHESIS; P WAVE; PERIPHERAL EDEMA; PRIORITY JOURNAL; QRS COMPLEX;

BODY WEIGHT; EDEMA; ELECTROCARDIOGRAPHY; HEART CONDUCTION SYSTEM; HUMANS; RENAL DIALYSIS;

EID: 18444415457     PISSN: 1082720X     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1542-474X.2005.05592.x     Document Type: Article

References (30)

1. Dilaveris PE, Gialafos EJ, Chrissos D, et al. Detection of hypertensive patients at risk for paroxysmal atrial fibrillation during sinus rhythm by computer-assisted P-wave analysis. J Hypertens 1999;17:1463-1470.
2. Dogan A, Acar G, Gedikli O, et al. A comparison of P-wave duration and dispersion in patients with short-term and long-term atrial fibrillation. J Electrocardiol 2003;36:251-255.
3. Turhan H, Yetkin E, Atak R. Increased P-wave duration and P-wave dispersion in patients with aortic stenosis. Ann Noninvasive Electrocardiol 2003;8:18-21.
4. Dilaveris PE, Gialafos EJ, Sideris SK, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135:733-738.
5. Chandy J, Nakai T, Lee RJ, et al. Increases in P-wave dispersion predict postoperative atrial fibrillation after coronary artery bypass graft surgery. Anesth Analg 2004;98:303-310.
6. Tezcan UK, Amasyali B, Can I, et al. Increased P wave dispersion and maximum P wave duration after hemodialysis. Ann Noninvasive Electrocardiol 2004;9:34-38.
7. Szabó Z, Kakuk G, Fülöp T, et al. Effects of haemodialysis on maximum P wave duration and P wave dispersion. Nephrol Dial Transplant 2002;17:1634-1638.
8. Chazan JA, Pono LM. Sudden death in patients with chronic renal failure on hemodialysis. Dial Transplant 1987;16:447.
9. Roithinger FX, Punzengruber C, Rossoll M, et al. Ventricular late potentials in haemodialysis patients and the risk of sudden death. Neph Dial Transplant 1992;7: 1013.
10. Shapira OM, Bar-Khayim Y. ECG changes and cardiac arrhythmias in chronic renal failure patients on hemodialysis. J Electrocardiol 1992;25:273.
11. Madias JE, Narayan V. Augmentation of the amplitude of electrocardiographic QRS complexes immediately after hemodialysis: A study of 26 hemodialysis sessions of a single patient, aided by measurements of resistance, reactance, and impedance. J Electrocardiol 2003;36:263-271.
12. Ishikawa K, Nagasawa T, Shimadu H. Influence of hemodialysis on electrocardiographic wave forms. Am Heart J 1979;97:5.
13. Diskin CJ, Salzsieder KH, Solomon RJ, et al. Electrocardiographic changes following dialysis. Nephron 1981;27:94.
14. Ono K, Hisasue Y, Kikawa K. Effects of dialysate sodium concentration on the appearance of ischemic EKG pattern. Nephron 1983;33:182.
15. Vitolo E, Madoi S, Palvarini M, et al. Relationship between changes in R wave voltage and cardiac volumes. A vector-cardiographic study during hemodialysis. J Electrocardiol 1987;20:138.
16. Fuenmayor AJ, Vasquez CJ, Fuenmayor AM, et al. Hemodialysis changes the QRS amplitude in the electrocardiogram. Int J Cardiol 1993;41:141.
17. Kinoshita O, Kimura G, Kamakura S, et al. Effects of hemodialysis on body surface maps in patients with chronic renal failure. Nephron 1993;64:580.
18. Ojanen S, Koobi T, Korhonen P, et al. QRS amplitude and volume changes during hemodialysis. Am J Nephrol 1999;19:423.
19. Madias JE. P-waves in patients with changing edematous states: Implications on interpreting repeat P-wave measurements in patients developing anasarca or undergoing hemodialysis. Pacing Clin Electrophysiol 2004;27:749-756.
20. Hewlett-Packard Interpretive Cardiograph. Physician's Guide. HP Part No.M1700-92908, 4th Edition, Printed in USA September 1994, pp. 4-1, 5-1, 7-1, 7-10, C-1.
21. Dilaveris PE, Gialafos JE. P-wave duration and dispersion analysis: Methodological considerations. Circulation (Letter to the Editor) 2001;103;e111.
22. Madias JE, Bazaz R, Agarwal H, et al. Anasarca-mediated attenuation of the amplitude of ECG complexes: A description of a heretofore unrecognized phenomenon. J Am Coll Cardiol 2001;38:756.
23. Madias JE. Decrease/disappearance of pacemaker stimulus "spikes" due to anasarca: Further proof that the mechanism of attenuation of ECG voltage with anasarca is extracardiac in origin. Ann Noninvasive Electrocardiol 2004;9:243-251.
24. Madias JE. Significance of shortening of the mean QRS duration of the standard electrocardiogram in patients developing peripheral edema. Am J Cardiol 2002;89:1444-1446.
25. Madias JE. Unpublished data.
26. Macfarlane PW, Vetch Lawrie TD. Comprehensive Electrocardiology. New York, Pergamon Press, 1989, pp. 197, 291, 449.
27. Rudy Y. The electrocardiogram and its relationship to excitation of the heart. In Sperelakis N (ed.): Physiology and Pathophysiology of the Heart, 3rd Edition, Amsterdam: Kluwer Academic Publishers, 1995, p. 20.
28. Rudy Y, Plonsey R. The eccentric model as the basis for the study of the role of geometry and inhomogeneities in electrocardiography. IEEE Trans Biomed Eng 1979;26:392.
29. Rudy Y, Plonsey R. A comparison of volume conductor and source geometry effects on body surface and epicardial potentials. Circ Res 1980;46:283.
30. Geddes LA, Baker LE. The specific resistance of biological material-a compendium of data for the biomedical engineer and physiologist. Med Biol Eng 1967;5:271.