Ventricular Arrhythmias in Hemodialysis Patients: A Study of Incidence and Contributory Factors
One hundred patients undergoing maintenance hemodialysis for chronic renal failure were evaluated by Holter ECG monitoring for a 72-hour period from the day of hemodialysis therapy. Eighteen patients (the frequent group) who had more than 700 premature ventricular contractions (PVCs) per day were found among these 100 patients. In those eighteen, the PVCs were recorded frequently during and for 4 hours after hemodialysis. The values of the serum calcium concentration times those of phosphorus, which are thought to be an index of parathyroid function, were significantly higher in the frequent group than in patients without PVCs (the no arrhythmia group) or in those with fewer PVCs (less than 700 beats per day; sporadic group). Also, in the frequent group, the percent fractional shortening of the left ventricle, as measured by 2-dimensional echocardiography, was significantly lower than those in the no arrhythmia and sporadic groups. From these results, we conclude that the pathogenesis of the PVCs in chronic renal failure resulted partially from impaired cardiac performance and accelerated parathyroid function.
KeywordsChronic Renal Failure Ventricular Arrhythmia Hemodialysis Patient Holter Monitoring Uremic Patient
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