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首页> 外文期刊>Circulation journal >Hemodialysis-Induced P-Wave Signal-Averaged Electrocardiogram Alterations Are Indicative of Vulnerability to Atrial Arrhythmias
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Hemodialysis-Induced P-Wave Signal-Averaged Electrocardiogram Alterations Are Indicative of Vulnerability to Atrial Arrhythmias

机译：血液透析引起的P波信号平均心电图改变表明房性心律不齐易受伤害

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Background: Atrial fibrillation (AF) is the most common supraventricular arrhythmia, often occurring during hemodialysis (HD). Prolongation of the total filtered P-wave duration (PWD) and reduction of the root mean square voltages for the last 20ms of the P wave (RMS20) on a P-wave signal-averaged electrocardiogram (P-SAECG) are predictors of AF. We investigated whether HD induces alterations of P-SAECG, and determined the influential factors. Methods and Results: Thirty-three end-stage kidney disease patients (66.7±12.6 years, 23 males) undergoing maintenance HD were enrolled in this study. Digital ambulatory P-SAECG monitoring and laboratory examination of serum proteins and ions were carried out before, during, and after the HD sessions. Data were analyzed by multiple regression analysis. PWD was significantly prolonged, and RMS20 significantly reduced, during HD. These values recovered after completion of HD. Multiple regression analysis showed that prolongation of PWD significantly correlated with HD duration and the rate of removal of body fluid. On the other hand, RMS20 significantly correlated with HD duration and blood urea nitrogen variation. Conclusions: HD resulted in prolongation of PWD and reduction of RMS20, indicating the vulnerability of HD patients to AF. These P-SAECG changes correlated with HD duration and the rate of removal of the body fluid. These findings underline the importance of the control of dialysis variables in the prevention of atrial arrhythmias following HD. ( Circ J 2012; 76: 612-617)
机译：背景：房颤（AF）是最常见的室上性心律失常，通常发生在血液透析（HD）期间。在P波信号平均心电图（P-SAECG）上，总滤波P波持续时间（PWD）的延长和P波最后20ms（RMS20）的均方根电压的降低是房颤的预测指标。我们调查了高清是否诱导P-SAECG的改变，并确定了影响因素。方法和结果：本研究纳入了接受维持性高清治疗的33例终末期肾脏病患者（66.7±12.6岁，男23例）。在高清会议之前，期间和之后，进行了数字化动态P-SAECG监测以及血清蛋白和离子的实验室检查。通过多元回归分析对数据进行分析。 HD期间PWD显着延长，而RMS20显着降低。 HD完成后，这些值将恢复。多元回归分析表明，PWD的延长与HD持续时间和体液清除率显着相关。另一方面，RMS20与HD持续时间和血液尿素氮变化显着相关。结论：HD导致PWD延长和RMS20降低，表明HD患者易患AF。这些P-SAECG变化与HD持续时间和体液清除率相关。这些发现强调了透析变量控制在预防HD后房性心律失常中的重要性。 （Circ J 2012; 76：612-617）

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