Abstract
Background/aims
The prolongation of the QT interval and dispersion could predict ventricular arrhythmias. It is not yet established whether there is a difference between the effects of hemodialysis and hemodiafiltration on QT interval duration and dispersion.
Methods
Data of thirty patients was investigated while they were receiving hemodiafiltration over a period of 3 months; then the same group of patients was evaluated during treatment with conventional hemodialysis for at least another 3 months. Ionic parameters and surface electrocardiograms (ECG) were analyzed five times during each session, and 2D, M-mode echocardiography and Holter ECGs were performed to acquire additional information.
Results
QT interval duration (QTmax) and dispersion (QTd) showed a significant increase during hemodialysis, but not during hemodiafiltration. QTmax was 388.66 ± 31.81 ms at the beginning of hemodialysis and increased to 400.66 ± 39.12 ms even at the 30th minute (p < 0.05). QTd was found to be 31.33 ± 10.08 ms before the commencement of hemodialysis with the largest prolongation being seen at the 240th minute (51.33 ± 14.56 ms, p < 0.05). The occurrence of ventricular premature beats was significantly higher during hemodialysis (p = 0.018). The left atrial diameter significantly decreased at the end of hemodiafiltration (at the beginning 45.1 ± 5.25 mm, at the end 40.77 ± 5.76 mm; p < 0.05).
Conclusion
Our results suggest a beneficial effect of hemodiafiltration on the studied electrocardiographic parameters compared to hemodialysis. The larger decrease in the left atrial diameter suggests a more efficient intracardiac volume-decreasing potential of hemodiafiltration.
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Acknowledgments
Our research project was sponsored by the TÁMOP-4.2.2.A-11/1/KONV-2012-0045 project. This project is implemented through the New Hungary Development Plan, co-financed by the European Union and the European Social Fund.
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None of the authors have relationship with companies that may have a financial or non-financial interest in the information contained in the manuscript.
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Barta, K., Czifra, Á., Kun, C. et al. Hemodiafiltration beneficially affects QT interval duration and dispersion compared to hemodialysis. Clin Exp Nephrol 18, 952–959 (2014). https://doi.org/10.1007/s10157-014-0950-9
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DOI: https://doi.org/10.1007/s10157-014-0950-9