Artikel
Can Hemodialysis Improve Time domain Signal Averaged ECG and 12-lead QT dispersion in End Stage Renal Failure Patients? A single centre experience in Taiwan
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Veröffentlicht: | 8. Februar 2007 |
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Gliederung
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Background: Time-domain signal-averaged electrocardiogram (SAECG) has been shown to have good negative predictive value in the evaluation of ventricular arrhythmias (VA) and increased 12-lead QT dispersion (QTd) has been associated with VA. The most important cause of death in End Stage Renal Failure (ESRF) patients under maintenance Hemodialysis is VA. The purpose of the present study is to evaluate if Hemodialysis can affect SAECG parameters and QTd in ESRF patients.
Materials and Methods: There were 122 normal Taiwanese and 29 ESRF Hemodialysis patients recruited for the study. Three standardize SAECG parameters, namely, filtered total QRS duration (fQRSd), duration of the low amplitude signals under 40 microV (LAS40), Root Mean Square voltage of the last 40 mS (RMS40), and standard 12-lead ECG QTd (max QT-Min QT) before and after Hemodialysis were evaluated. There were no statistically significant differences in both QT and QTC before and after hemodialysis. Comparisons were analysed by Student’s t test for both paired and unpaired data to assess the significance of differences. P<0.05 was considered as statistically significant.
Results: In 12-lead ECG analysis, QTd in ESRF before Hemodialysis is significantly greater than normal (31.3 ±10.5 versus 26.5 ± 8.1) ms (p<0.05) and QTd decreased significantly to 23.0 ± 8.8 ms after Hemodialysis (p=0.001). In SAECG evaluation, Hemodialysis was shown to have no significant effects on both RMS40 and LAS40 of SAECG but the fQRSd significantly prolong from 81.0 ± 18.4 ms to 95.2 ± 35.7 ms (p<0.001).
Conclusions: Hemodialysis can improve the QTd and fQRSd, therefore, the incidence of ventricular arrhythmias might be reduced in ESRF patients through this procedure.
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