The effect of hemodialysis on cardiac rhythm and performance

The effects of hemodialysis on cardiac rhythm and left ventricular function were evaluated by Holter electrocardiographic monitoring and M-mode echocardiography in 22 stable patients on regular hemodialysis in hospital. Significant ventricular arrhythmias occurred in 9%. Mean left ventricular volume in diastole (LVVd) decreased significantly after dialysis from 156 +/- 12 ml to 135 +/- 9 ml (P less than 0.001). Similarly, mean left ventricular volume in systole (LVVs) decreased from 51 +/- 9 ml to 42 +/- 6 ml (P less than 0.025). Left ventricular function, as measured by mean velocity of circumferential fiber shortening (VCF), increased significantly for the entire group from 1.25 +/- 0.06 circ/sec to 1.38 +/- 0.06 circ/sec (P less than 0.05). Pre-dialysis VCF was normal in 15 patients (Group 1) and abnormal (less than 1.10 circ/sec) in 7 patients (Group 2). The mean VCF after VCF after dialysis did not change in Group 1 (1.40 +/- 0.05 circ/sec to 1.42 +/- 0.06 circ/sec, P = NS) but increased significantly in Group 2 (0.92 +/- 0.06 circ/sec to 1.29 +/- 0.12 circ/sec, P less than 0.005). There was no significant change in cardiac output or peripheral vascular resistance. Hemodialysis, when performed with careful potassium monitoring, has a low incidence of ventricular arrhythmias. In addition, hemodialysis reduces left ventricular volumes and improves overall cardiac performance in patients with abnormal left ventricular function predialysis.