A pilot study in hemodialysis of an electrophysiological tool to measure sudden cardiac death risk

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Abstract

Background: The hemodialysis procedure may play a role in the elevated risk of sudden cardiac death seen in hemodialysis patients. Methods: Microvolt T wave alternans, a promising noninvasive electrophysiological test developed to measure sudden cardiac death risk, was used to test the hypotheses that high-risk hemodialysis patients commonly manifest cardiac electrophysiology that is associated with higher sudden death risk in nondialysis patients and that the hemodialysis procedure modifies cardiac electrophysiology in a manner predisposing to malignant ventricular arrhythmias. To test this hypothesis, microvolt T wave alternans tracings were done in 9 patients before and immediately after an early week hemodialysis session. Results: 7 of 9 individuals had non-negative (i.e. higher risk) tracings either before or after hemodialysis. 2 of 4 subjects with tracings initially negative before hemodialysis became non-negative after hemodialysis. Conclusion: This pilot study provides the first objective preliminary evidence using microvolt T wave alternans that high-risk hemodialysis patients commonly exhibit abnormal cardiac repolarization and that hemodialysis treatments can acutely alter repolarization in a potentially harmful manner.

Original languageEnglish
Pages (from-to)159-164
Number of pages6
JournalClinical Nephrology
Volume68
Issue number3
StatePublished - Sep 2007

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Sudden Cardiac Death
Renal Dialysis
Cardiac Electrophysiology
Sudden Death
Cardiac Arrhythmias

Keywords

  • Arrhythmia
  • Dialysis
  • Sudden cardiac death
  • T wave alternans

ASJC Scopus subject areas

  • Nephrology

Cite this

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title = "A pilot study in hemodialysis of an electrophysiological tool to measure sudden cardiac death risk",
abstract = "Background: The hemodialysis procedure may play a role in the elevated risk of sudden cardiac death seen in hemodialysis patients. Methods: Microvolt T wave alternans, a promising noninvasive electrophysiological test developed to measure sudden cardiac death risk, was used to test the hypotheses that high-risk hemodialysis patients commonly manifest cardiac electrophysiology that is associated with higher sudden death risk in nondialysis patients and that the hemodialysis procedure modifies cardiac electrophysiology in a manner predisposing to malignant ventricular arrhythmias. To test this hypothesis, microvolt T wave alternans tracings were done in 9 patients before and immediately after an early week hemodialysis session. Results: 7 of 9 individuals had non-negative (i.e. higher risk) tracings either before or after hemodialysis. 2 of 4 subjects with tracings initially negative before hemodialysis became non-negative after hemodialysis. Conclusion: This pilot study provides the first objective preliminary evidence using microvolt T wave alternans that high-risk hemodialysis patients commonly exhibit abnormal cardiac repolarization and that hemodialysis treatments can acutely alter repolarization in a potentially harmful manner.",
keywords = "Arrhythmia, Dialysis, Sudden cardiac death, T wave alternans",
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T1 - A pilot study in hemodialysis of an electrophysiological tool to measure sudden cardiac death risk

AU - Friedman, Allon

AU - Groh, William

AU - Das, Mithilesh

PY - 2007/9

Y1 - 2007/9

N2 - Background: The hemodialysis procedure may play a role in the elevated risk of sudden cardiac death seen in hemodialysis patients. Methods: Microvolt T wave alternans, a promising noninvasive electrophysiological test developed to measure sudden cardiac death risk, was used to test the hypotheses that high-risk hemodialysis patients commonly manifest cardiac electrophysiology that is associated with higher sudden death risk in nondialysis patients and that the hemodialysis procedure modifies cardiac electrophysiology in a manner predisposing to malignant ventricular arrhythmias. To test this hypothesis, microvolt T wave alternans tracings were done in 9 patients before and immediately after an early week hemodialysis session. Results: 7 of 9 individuals had non-negative (i.e. higher risk) tracings either before or after hemodialysis. 2 of 4 subjects with tracings initially negative before hemodialysis became non-negative after hemodialysis. Conclusion: This pilot study provides the first objective preliminary evidence using microvolt T wave alternans that high-risk hemodialysis patients commonly exhibit abnormal cardiac repolarization and that hemodialysis treatments can acutely alter repolarization in a potentially harmful manner.

AB - Background: The hemodialysis procedure may play a role in the elevated risk of sudden cardiac death seen in hemodialysis patients. Methods: Microvolt T wave alternans, a promising noninvasive electrophysiological test developed to measure sudden cardiac death risk, was used to test the hypotheses that high-risk hemodialysis patients commonly manifest cardiac electrophysiology that is associated with higher sudden death risk in nondialysis patients and that the hemodialysis procedure modifies cardiac electrophysiology in a manner predisposing to malignant ventricular arrhythmias. To test this hypothesis, microvolt T wave alternans tracings were done in 9 patients before and immediately after an early week hemodialysis session. Results: 7 of 9 individuals had non-negative (i.e. higher risk) tracings either before or after hemodialysis. 2 of 4 subjects with tracings initially negative before hemodialysis became non-negative after hemodialysis. Conclusion: This pilot study provides the first objective preliminary evidence using microvolt T wave alternans that high-risk hemodialysis patients commonly exhibit abnormal cardiac repolarization and that hemodialysis treatments can acutely alter repolarization in a potentially harmful manner.

KW - Arrhythmia

KW - Dialysis

KW - Sudden cardiac death

KW - T wave alternans

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