Major arrhythmic events and T wave morphology descriptors in hemodialyzed patients

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).

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.

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

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