Background: Prevalence and incidence of atrial fibrillation (AF) are high in hemodialysis (HD) patients. Intra-atrial conduction velocity slowing plays an important role in AF onset. The aim of our study was to measure P wave duration (Pwd), expression of intra-atrial conduction velocity, in HD patients with and without a history of AF. Methods: The study was performed in 47 end stage renal disease (ESRD) patients, subdivided into four groups: 19 patients within the first 6 months from starting HD therapy (HD1); the same patients studied 18 ± 3 months later (HD2); patients with no history of AF and long dialytic age (HD3, n = 13); and patients with sinus rhythm but history of AF (HDAF, n = 15); and 18 healthy controls. In all patients P wave high resolution recording and electrolyte plasma values were obtained before and after a HD session, and atrial diameter was assessed by echocardiography. Results: Patients with the shortest dialysis vintage showed the shortest Pwd [131.2 ± 11.0 (HD1) vs. 139.8 ± 11.7 (HD2), 142.1 ± 7.2 (HD3), 152.3 ± 15.0 (HDAF) ms; p < 0.05], while Pwd was prolonged in patients with AF history when compared to all other groups (p < 0.03). At multivariate analysis atrial dimension was independently related to Pwd (R = 0.40, p < 0.02). HD session induced a significant increase of Pwd (141 ± 14.0–152 ± 17.0 ms, p < 0.001), that was correlated to modifications of K+ concentration (R = 0.8, p < 0.0001). Conclusions: HD therapy prolongs Pwd. HD patients with a history of AF have prolonged Pwd compared to patients without, suggesting that increased Pwd is a marker of AF risk in patients with ESRD. HD session acutely increases Pwd, creating conditions favoring AF onset.

Genovesi, S., Fabbrini, P., Pieruzzi, F., Galbiati, E., Sironi, E., Pogliani, D., et al. (2015). Atrial fibrillation in end stage renal disease patients: influence of hemodialysis on P wave duration and atrial dimension. JN. JOURNAL OF NEPHROLOGY, 28(5), 615-621 [10.1007/s40620-014-0131-7].

Atrial fibrillation in end stage renal disease patients: influence of hemodialysis on P wave duration and atrial dimension

GENOVESI, SIMONETTA CARLA
;
PIERUZZI, FEDERICO UMBERTO EMILIO GUGLIE;STELLA, ANDREA
2015

Abstract

Background: Prevalence and incidence of atrial fibrillation (AF) are high in hemodialysis (HD) patients. Intra-atrial conduction velocity slowing plays an important role in AF onset. The aim of our study was to measure P wave duration (Pwd), expression of intra-atrial conduction velocity, in HD patients with and without a history of AF. Methods: The study was performed in 47 end stage renal disease (ESRD) patients, subdivided into four groups: 19 patients within the first 6 months from starting HD therapy (HD1); the same patients studied 18 ± 3 months later (HD2); patients with no history of AF and long dialytic age (HD3, n = 13); and patients with sinus rhythm but history of AF (HDAF, n = 15); and 18 healthy controls. In all patients P wave high resolution recording and electrolyte plasma values were obtained before and after a HD session, and atrial diameter was assessed by echocardiography. Results: Patients with the shortest dialysis vintage showed the shortest Pwd [131.2 ± 11.0 (HD1) vs. 139.8 ± 11.7 (HD2), 142.1 ± 7.2 (HD3), 152.3 ± 15.0 (HDAF) ms; p < 0.05], while Pwd was prolonged in patients with AF history when compared to all other groups (p < 0.03). At multivariate analysis atrial dimension was independently related to Pwd (R = 0.40, p < 0.02). HD session induced a significant increase of Pwd (141 ± 14.0–152 ± 17.0 ms, p < 0.001), that was correlated to modifications of K+ concentration (R = 0.8, p < 0.0001). Conclusions: HD therapy prolongs Pwd. HD patients with a history of AF have prolonged Pwd compared to patients without, suggesting that increased Pwd is a marker of AF risk in patients with ESRD. HD session acutely increases Pwd, creating conditions favoring AF onset.
Articolo in rivista - Articolo scientifico
Atrial fibrillation, hemodialysis, P wave, atrium
English
2015
28
5
615
621
none
Genovesi, S., Fabbrini, P., Pieruzzi, F., Galbiati, E., Sironi, E., Pogliani, D., et al. (2015). Atrial fibrillation in end stage renal disease patients: influence of hemodialysis on P wave duration and atrial dimension. JN. JOURNAL OF NEPHROLOGY, 28(5), 615-621 [10.1007/s40620-014-0131-7].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/62100
Citazioni
  • Scopus 6
  • ???jsp.display-item.citation.isi??? 6
Social impact