title: Augmentation of ECG QRS complexes after fluid removal via a mechanical ultrafiltration pump in patients with congestive heart failure.
abstract: BACKGROUND
  Augmentation of the amplitude of ECG QRS complexes, correlating with loss of weight or fluid volume removed, has been documented in patients with congestive heart failure (CHF).
  
  
  METHODS
  We investigated the effect of an ultrafiltration (UF) pump on the fluid removal and the amplitude of ECG QRS complexes in patients with CHF. Nine patients aged 48.3 +/- 10.4 years with CHF were treated with an UF system, and weights, fluid removed, and sums of the amplitude of QRS complexes (SigmaQRS), were inter-correlated.
  
  
  RESULTS
  UF resulted in removal of 4.62 +/- 1.82 L of fluid, 5.0 +/- 2.9% decrease in the weights (P = 0.002) and 18.1 +/- 16.8% increase in the SigmaQRS (P = 0.012). There was a moderate correlation of % increase in the SigmaQRS and net fluid volume losses (UF + urine - oral intake), (r = 0.67, P = 0.0471, and a poor correlation between % increase in the SigmaQRS and % decrease in weights (r = 0.11, P = 0.77). Correlations of the change in weights after UF with the fluid removed by UF, or with the volume of total fluid loss (including insensible losses) were moderate but barely statistically significant (r = 0.65, P = 0.0559), and (r = 0.65, P = 0.0577), correspondingly.
  
  
  CONCLUSIONS
  Augmentation of the amplitude of QRS complexes correlates well with net fluid loss in response to UF in patients with CHF, and can be employed as an index of effectiveness of therapy. Also, a model of fluid losses in patients treated for CHF is being proposed.
authors.affiliation: Mount Sinai School of Medicine of the New York University, Division of Cardiology, Elmhurst Hospital Center, Elmhurst, New York, USA. madiasj@nychhc.org
authors.forename: John E
authors.initials: JE
authors.lastname: Madias
authors.forename: Maya E
authors.initials: ME
authors.lastname: Guglin
mesh_terms: D000328:Adult; D000368:Aged; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014462:Ultrafiltration / Q000295:instrumentation*