Determinants of ventricular arrhythmias in hemodialysis patients. Evaluation of the effect of arrhythmogenic substrate and autonomic imbalance

American Journal of Nephrology
K TamuraT Iwasaka

Abstract

In chronic hemodialysis patients, we evaluated determinants of repetitive ventricular tachyarrhythmias which included late potentials and heart rate variability. We compared the presence of late potentials and heart rate variability obtained by ambulatory electrocardiogram (ECG), findings of echocardiography, and laboratory data between patients with and those without ventricular arrhythmias of Lown class 4A or 4B. Ambulatory ECG was recorded for 24 h from the beginning of hemodialysis. Heart rate variability was evaluated by the standard deviation of the normal RR interval (SDNN). Thirty patients (17%) had ventricular arrhythmias of Lown class 4A or 4B. They were older than patients without such arrhythmias (p=0.0021). Left-ventricular wall motion score (2.0+/-3.9 and 0.3+/-1.2, respectively, p < 0.0001) and left-ventricular mass index (167 +/-59 and 140+/-44 g/m2, respectively, p=0.0053) were larger in patients with ventricular arrhythmias of Lown class 4A or 4B than in those without. Stepwise logistic regression analysis was performed to select variables related to ventricular arrhythmias of Lown class 4A or 4B from the following 8 candidate variables; age, sex, presence of ischemic heart disease, diabetic nephropathy as the...Continue Reading

Citations

Mar 18, 2010·Circulation. Cardiovascular Quality and Outcomes·Rajat DeoMichael G Shlipak
Jun 8, 2000·Renal Failure·A S NarulaR P Sapru
Apr 13, 2011·Hemodialysis International·Serkan SaygiErcan Ok
Dec 12, 2001·Kidney International·D J Goldsmith, A Covic
Oct 28, 2004·Autonomic Neuroscience : Basic & Clinical·Gwidon PolakRomuald Przybył
Jul 9, 2004·Advances in Chronic Kidney Disease·Peter A McCullough
Oct 17, 2001·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M J Schreiber

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