title: A pilot study in hemodialysis of an electrophysiological tool to measure sudden cardiac death risk.
abstract: BACKGROUND
  The hemodialysis procedure may play a role in the elevated risk of sudden cardiac death seen in hemodialysis patients.
  
  
  METHODS
  Microvolt T wave alternans, a promising noninvasive electrophysiological test developed to measure sudden cardiac death risk, was used to test the hypotheses that high-risk hemodialysis patients commonly manifest cardiac electrophysiology that is associated with higher sudden death risk in nondialysis patients and that the hemodialysis procedure modifies cardiac electrophysiology in a manner predisposing to malignant ventricular arrhythmias. To test this hypothesis, microvolt T wave alternans tracings were done in 9 patients before and immediately after an early week hemodialysis session.
  
  
  RESULTS
  7 of 9 individuals had non-negative (i.e. higher risk) tracings either before or after hemodialysis. 2 of 4 subjects with tracings initially negative before hemodialysis became non-negative after hemodialysis.
  
  
  CONCLUSIONS
  This pilot study provides the first objective preliminary evidence using microvolt T wave alternans that high-risk hemodialysis patients commonly exhibit abnormal cardiac repolarization and that hemodialysis treatments can acutely alter repolarization in a potentially harmful manner.
authors.affiliation: Division of Nephrology, Indiana University, Indianapolis, IN, USA. allfried@iupui.edu
authors.forename: A N
authors.initials: AN
authors.lastname: Friedman
authors.forename: W J
authors.initials: WJ
authors.lastname: Groh
authors.forename: M
authors.initials: M
authors.lastname: Das
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D014693:Ventricular Fibrillation / Q000209:etiology*