[Ventricular arrhythmias in patients on chronic hemodialysis]

Prospective, comparative, multifactorial study was undertaken to examine occurrence, frequency and type of ventricular arrhythmias (VA) in patients of both sexes undergoing chronic haemodialysis using 24-hour method of dynamic electrocardiography (Holter). This research considered 100 patients divided into Experimental et Control group. 54% of HD patients suffered from PVC (36% Men and 18% Women). The distribution of VA (PVC) in the Experimental (E) group according to Lown was: 0-46%, I-40%, II-6%, III-6%, IVA-16%, IVB-6%, V-2%. 20% of patients from the E-group suffered from complex PVC of higher degree simultaneously with distribution within the age groups over 40 years of age. The same occurrence was not notified in the Control (C) group. Variability of PVC occurrence was higher in HD group then in the C-group for all three criteria: a) Average number of patients with PVC during 1 hour--E:C group--6.79:4.21, b) Average number of PVC during 1 hour--E:C group--106.08:11.16, c) Average number of PVC for a single patient during 1 hour--E:C group--14.09:2.72. Occurrence in the E-group was the most frequent from 1-6 hrs and in the C-group 3-8 hrs of monitoring. 48% of patients from the HD group compared with 18% of patients from the C-group had significantly lowered ST-segment. Patients diary indicated dominating silent-ischaemia. There is a statistically significant difference in the positivity of ST-segment with regards to sex M:W-3:1 (Hi2-18,954, p < 0.01). 78% of patients from HD group showed pathological ECG results compared to 8% in the C-group. HD is potentially arrythmogenic procedure in patients with preexisting cardial disease. On the other hand, the value of yearly Holter-monitoring in patients with preexisting cardial disease undergoing the programme of intermittent chronic HD, is undeniable.