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Atrial Electromechanical Delay and P-wave Dispersion Before and After Haemodialysis in Patients with End-stage Renal Failure



Background: Electromechanical delay (EMD) has been defined as the temporal interval between the onset of cardiac electrical activity and myocardial contraction. Atrial EMD is considered as an independent predictor of atrial fibrillation. In this study, we sought to evaluate the effect of hemodialysis (HD) on atrial electromechanical properties and conduction homogeneity in patients with end-stage renal failure (ESRF).

Methods: Forty-nine ESRF patients on regular HD were enrolled. PA interval was defined as the duration between beginning of P-wave on simultaneous electrocardiographic tracing and onset of A′-wave on tissue Doppler tracings, which was measured from tricuspid, septal, and lateral mitral annuli and named as tricuspid PA, septal PA and lateral PA, respectively. The difference between maximum and minimum P-wave durations was defined as P-wave dispersion (Pd).

Results: A total of 49 subjects (17 male) with a mean age of 51±16 years were included in the study. Septal and lateral PA durations were significantly lower after HD compared to pre-HD period; however, there was no statistically significant difference regarding tricuspid PA intervals between pre- and post-HD periods (p=0.066).

While left intra-atrial and inter-atrial electromechanical delays were significantly lower in post-HD period, right intra-atrial electromechanical delay was similar before and after HD. P-maximum, P-minimum and Pd were also shortened after HD.

Conclusion: This study demonstrated that atrial electromechanical coupling intervals and Pd are volume dependent and both of them are shortened after HD. Further prospective studies are needed to clarify the value of AEMCT and Pd improvement with hemodialysis in the maintenance of sinus rhythm in ESRF patients. 

27 Apr, 2015
e-Published: 09 Jul, 2015


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