[The influence of hemodialysis on heart's intraventricular conduction system--pilot study].
The highest percent of cardiac muscle damages is written down in children which are exposed to hemodialysis. In this group the heart examinations using body surface heart potential mapping (BSPM) method have been carried out. The aim of the study was to assess the influence of hemodialysis on heart's electrodynamics in children and adolescent during replacement therapy.


METHODS
Multielectrode recording have been done in every kid before and after hemodialysis. For every record it was created isopotential map. By the comparing our maps with model maps for healthy children it was affirmed that in greater part of studied examples of hemodialysed children there are present early changes indicating conducting disturbances in left bundle of fasciculus atrioventricularis (His) and initial stage of left ventricular hypertrophy (LVH). That changes haven't been confirmed in classic ECG, which suggests that the disturbances in excitation conductance observed on isointegral maps are far beyond the area detected by 12-electrode classic ECG recording.


RESULTS
The maps made before dialysis are characterised by large, unsymmetrical isopotential lines changes over the left and right ventricle. After carried out of hemodialysis the image of ECG records was improving. In all of cases the isoline distribution in sternal and anterior lower left part of chest comes back to norm. Changes are visible merely over the left ventricle and in anterior upper right part of chest what is connected with just stabilised conducting disturbances in the left branch of His bundle, left bundle of fasciculus atrioventricularis (His bundle).


CONCLUSIONS
1. In children who are treated by repeated hemodialysis approach to disturbances in the cardiac intraventricular conduction system. 2. Those disturbances are improved by a singular hemodialysis. 3. BSPM method detects earlier changes in the cardiac intraventricular conduction system than the classical ECG.
Polak-Jonkisz
Dorota
D
Medical University of Wroclaw, Department of Pediatric Nephrology. dpjonkisz@nefped.am.wroc.pl
Laszki-Szczachor
Krystyna
K
Zwolińska
Danuta
D
Rusiecki
Lesław
L
Miler
Maria
M
Sobieszczańska
Małgorzata
M
D000293:Adolescent; D018780:Body Surface Potential Mapping; D002648:Child; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology; D008297:Male; D010865:Pilot Projects; D006435:Renal Dialysis / Q000009:adverse effects