Visual Three-Dimensional Representation of Beat-to-Beat Electrocardiogram Traces During Hemodiafiltration
Rodrigo Rodriguez-Fernandez
Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología “Ignacio Chávez”
Search for more papers by this authorOscar Infante
Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología “Ignacio Chávez”
Search for more papers by this authorHéctor Perez-Grovas
Departamento de Nefrología, Instituto Nacional de Cardiología “Ignacio Chávez,” Mexico, DF
Search for more papers by this authorErika Hernandez
División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, Mexico
Search for more papers by this authorPatricia Ruiz-Palacios
Departamento de Nefrología, Instituto Nacional de Cardiología “Ignacio Chávez,” Mexico, DF
Search for more papers by this authorMartha Franco
Departamento de Nefrología, Instituto Nacional de Cardiología “Ignacio Chávez,” Mexico, DF
Search for more papers by this authorCorresponding Author
Claudia Lerma
Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología “Ignacio Chávez”
Dr. Claudia Lerma, Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología “Ignacio Chávez,” Juan Badiano No. 1 Col Sección XVI, Del. Tlalpan CP 14080, México, D.F. Mexico. E-mail: [email protected]Search for more papers by this authorRodrigo Rodriguez-Fernandez
Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología “Ignacio Chávez”
Search for more papers by this authorOscar Infante
Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología “Ignacio Chávez”
Search for more papers by this authorHéctor Perez-Grovas
Departamento de Nefrología, Instituto Nacional de Cardiología “Ignacio Chávez,” Mexico, DF
Search for more papers by this authorErika Hernandez
División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, Mexico
Search for more papers by this authorPatricia Ruiz-Palacios
Departamento de Nefrología, Instituto Nacional de Cardiología “Ignacio Chávez,” Mexico, DF
Search for more papers by this authorMartha Franco
Departamento de Nefrología, Instituto Nacional de Cardiología “Ignacio Chávez,” Mexico, DF
Search for more papers by this authorCorresponding Author
Claudia Lerma
Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología “Ignacio Chávez”
Dr. Claudia Lerma, Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología “Ignacio Chávez,” Juan Badiano No. 1 Col Sección XVI, Del. Tlalpan CP 14080, México, D.F. Mexico. E-mail: [email protected]Search for more papers by this authorPresented in abstract form at the 42nd Annual Meeting of the American Society of Nephrology, held October 27–November 1, 2009 in San Diego, CA, USA.
Abstract
This study evaluated the usefulness of the three-dimensional representation of electrocardiogram traces (3DECG) to reveal acute and gradual changes during a full session of hemodiafiltration (HDF) in end-stage renal disease (ESRD) patients. Fifteen ESRD patients were included (six men, nine women, age 46 ± 19 years old). Serum electrolytes, blood pressure, heart rate, and blood urea nitrogen (BUN) were measured before and after HDF. Continuous electrocardiograms (ECGs) obtained by Holter monitoring during HDF were used to produce the 3DECG. Several major disturbances were identified by 3DECG images: increase in QRS amplitude (47%), decrease in T-wave amplitude (33%), increase in heart rate (33%), and occurrence of arrhythmia (53%). Different arrhythmia types were often concurrent and included isolated supraventricular premature beats (N = 5), atrial fibrillation or atrial bigeminy (N = 2), and isolated premature ventricular beats (N = 6). Patients with decrease in T-wave amplitude had higher potassium and BUN (both before HDF and total removal) than those without decrease in T-wave amplitude (P < 0.05). Concurrent acute and gradual ECG changes during HDF are identified by the 3DECG, which could be useful as a preventive and prognostic method.
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