Major arrhythmic events and T wave morphology descriptors in hemodialyzed patients

Background: Sudden cardiac death is common in patients receiving regular hemodialysis (HD). We recently demonstrated that selected repolarization descriptors calculated from electrocardiographic monitoring during HD demonstrate intra-subject stability. In this study we followed up the initial cohort for major arrhythmic events (MAE).

Methods: Holter electrocardiograms (ECGs) were recorded during dialysis in 81 HD patients and repeated 5 times at 2 week intervals. The QRS-to-T angle (TCRT), the principal component analysis (PCA) ratio and the T wave morphology dispersion (TMD) were calculated in overlapping 10 second ECG segments and averaged overall recordings in each patient. Patients were followed up for MAE and non-arrhythmic mortality.

Results: During 18 ± 3 months, 3 patients experienced MAE. Compared to others, MAE patients exhibited extreme TCRT and TMD values and minimal intradialytic changes.

Conclusion: The prognostic value of repolarization descriptors from intradialytic monitoring should be assessed prospectively.