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Nephrol Dial Transplant (2002) 17: 1634-1638
© 2002 European Renal Association-European Dialysis and Transplant Association

Effects of haemodialysis on maximum P wave duration and P wave dispersion

Zoltán Szabó, György Kakuk, Tibor Fülöp1, János Mátyus, József Balla, István Kárpáti, Attila Juhász, Csaba Kun1, Zsolt Karányi and István Lorincz

1 First Department of Medicine and Department of Cardiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary

Background. Analysing a 12-lead surface electrocardiogram (ECG), the inter-lead variability of the P wave interval, i.e. P wave dispersion, is defined as the difference between the maximum and the minimum P wave duration. Our aim was to assess the effect of haemodialysis on P wave duration and dispersion in non-diabetic patients with end-stage renal failure on chronic haemodialysis.

Methods. Twenty-eight patients (14 men and 14 women, mean age 58±16 years, average duration of dialysis 4.5±2.8 years) were examined. Prior to haemodialysis, echocardiography (M-mode and two-dimensional) was performed. Haemodialysis sessions were carried out with polysulfone dialysers and bicarbonate dialysate fluids. Twelve-lead ECGs were recorded at the beginning, 15 and 30 min after starting dialysis, at the end, and 2 h after completion of each session. Ionic parameters were checked during the study. P wave durations were measured with calipers in three consecutive complexes of each lead by one observer.

Results. P maximum was 58±16 ms at the beginning, and showed an increase by the end of dialysis to 98±8.9 ms (P<0.0001). Pre-dialysis P dispersion was 23±10 ms and increased to 41±16 ms by the end of the sessions (P<0.0001). In patients with a left atrial diameter larger than 45 mm, P dispersion increased from 23±11 to 53±10 ms (P<0.0003) by the end of the sessions.

Conclusions. According to our results, ionic imbalance and dialysis itself may cause changes in P duration and dispersion simultaneously.

Keywords: atrial fibrillation; haemodialysis; P wave dispersion; P wave duration

Correspondence and offprint requests to: István Lorincz, MD, PhD, Debrecen, Dóczy u. 24., H-4032, Hungary. Email: lorincz{at}ibel.dote.hu


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